Dermatitis Herpetiformis: Clinical Exploration, Underlying Pathogenesis and Therapeutic Advances

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Published: Aug 24, 2023
DOI: https://doi.org/10.47191/ijmscrs/v3-i8-52
Keywords:
Dermatitis, Herpetiformis, skin, disease

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Patricia Flores Troche
Hospital General Regional 200 Tecamac Instituto Mexicano del Seguro Social. Residente de medicina interna/UNAM Universidad Latina de México.
Salmahk Karen Avilés Tenorio
Instituto Mexicano del Seguro Social. Hospital General de Zona 14 La Paz. Guadalajara, Jalisco, México.
Jaime Picazo Luna
Hospital General de Zona 194 Instituto Mexicano del Seguro Social. Naucalpan de Juárez, México.
Maria Reyna Lara Guevara
Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Clínica hospital Irapuato, Guanajuato, México.
Néstor Daniel Rodriguez Trujillo
Instituto Politécnico Nacional, Campus Celaya. Celaya, México.
Diana Karina Conejo Chávez
Instituto Politécnico Nacional, Campus Celaya. Celaya, México.

Abstract

Dermatitis herpetiformis (DH) emerges as a chronic, immune-mediated, systemic skin pathology closely linked to celiac disease (CD). Characterized by polymorphous and pruritic cutaneous manifestations, DH presents a unique clinical and diagnostic challenge. In this article, we seek to comprehensively delineate the clinical, histologic, and immunologic dimensions of DH, with particular emphasis on its etiopathogenic association with CD. The underlying autoimmune cascade involving the interaction between immunoglobulin A (IgA) and tissue transglutaminase is examined, with crucial implications in the pathogenesis of DH.


As understanding of immunologic mechanisms expands, the diverse spectrum of clinical presentations of DH is explored, highlighting the variability in skin lesion morphology and its correlation with histologic findings. In the therapeutic arena, conventional and emerging approaches are reviewed, ranging from dapsone-based drug therapy to nutritional and pharmacologic interventions aimed at suppressing the abnormal immune response. As research advances, it is essential to further the early diagnosis and integrated management of DH, addressing both cutaneous symptoms and systemic implications, to improve patients' quality of life and provide comprehensive and insightful clinical care.

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How to Cite
Patricia Flores Troche, Salmahk Karen Avilés Tenorio, Jaime Picazo Luna, Maria Reyna Lara Guevara, Néstor Daniel Rodriguez Trujillo, & Diana Karina Conejo Chávez. (2023). Dermatitis Herpetiformis: Clinical Exploration, Underlying Pathogenesis and Therapeutic Advances. International Journal of Medical Science and Clinical Research Studies, 3(8), 1719–1722. https://doi.org/10.47191/ijmscrs/v3-i8-52
Issue
Vol. 3 No. 8 (2023): Volume 03 Issue 08 August 2023
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Articles
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This work is licensed under a Creative Commons Attribution 4.0 International License.

References

I. Mendes FBR, Hissa-Elian A, De Abreu MA and Gonçalves VS, Review: dermatitis herpetiformis, An Bras Dermatol 2013; 88:594-9 .

II. Fry L, Dermatitis herpetiformis: problems, progress and prospects, European Journal of Dermatology 2002; 12(6):523-31.

III. Bolotin D, and Petronic-Rosic V, Dermatitis herpetiformis: Part ii. Diagnosis, management, and prognosis, Journal of the American Academy of Dermatology 2011; 64(6)1027-33.

IV. Caproni M, Antiga E, Melani L and Fabbri P, Guidelines for the diagnosis and treatment of dermatitis herpetiformis, Journal of the European Academy of Dermatology and Venereology 2009; 23(6):633-8.

V. Hervonen K et al, Reduced mortality in dermatitis herpetiformis: a population-based study of 476 patients, Br J Dermatol 2012; 167(6)1331-7.

VI. Bolotin D and Petronic-Rosic V, Dermatitis herpetiformis: Part i. Epidemiology, pathogenesis, and clinical presentation, J Am Acad Dermatol 2011; 64:1017-24.

VII. Bonciani D et al, Dermatitis herpetiformis: from the genetics to the development of skin lesions, Clin Dev Immunol 2012; 1:239691.

VIII. Alonso-Llamazares J, Gibson LE and Rogers RS, Clinical, pathologic, and immunopathologic features of dermatitis herpetiformis: review of the Mayo Clinic experience, Int J Dermatol 2007; 46:910-9.

IX. Lever's histopathology of the skin, 10th ed, J Cutan Pathol-Wiley Online Library, 2009.

X. Reunala TL, Dermatitis herpetiformis, Clinics in Dermatology 2001; 144:196-7.

XI. Zone JJ, Meyer LJ and Petersen MJ, Deposition of granular iga relative to clinical lesions in dermatitis herpetiformis, Arch Dermatol 1996; 132(8):912-8.

XII. Dieterich W et al, Antibodies to tissue transglutaminase as serologic markers in patients with dermatitis herpetiformis, J Invest Dermatol 1999; 113(1)133-6.

XIII. Sárdy M, Kárpáti S, Merkl B, Paulsson M and Smyth N, Epidermal transglutaminase (tgase 3) is the autoantigen of dermatitis herpetiformis, J Exp Med 2002; 195(6):747-57.

XIV. Zone JJ et al, Dermatitis herpetiformis sera or goat anti-transglutaminase-3 transferred to human skin-grafted mice mimics dermatitis herpetiformis immunopathology, J Immunol 2011; 186(7):4474-80.

XV. Mobacken H, Kastrup W and Nilsson LA, Incidence and prevalence of dermatitis herpetiformis in Western Sweden, Acta Derm Venereol 1984; 64(5):400-4.

XVI. Reunala T and Lokki J, Dermatitis herpetiformis in Finland, Acta Derm Venereol 1978.

XVII. Smith JB, Tulloch JE, Meyer LJ, and Zone JJ, The incidence and prevalence of dermatitis herpetiformis in Utah, Arch Dermatol 1992; 128:1608-10.

XVIII. Lanzini A et al, Epidemiological, clinical and histopathologic characteristics of celiac disease: results of a case-finding population-based program in an Italian community, Scand J Gastroenterol 2005; 40(8)950-7.

XIX. Llorente-Alonso MJ, Fernández-Aceñero MJ and Sebastián M, Gluten intolerance: sex- and age-related features, Can J Gastroenterol 2006; 20(11)719-22.