A skin biopsy from a vesicular eruption over the elbows and buttocks shows neutrophilic microabscesses at the dermal papillary tips with subepidermal blistering. DIF reveals granular IgA deposits at dermal papillary tips. Which associated condition must be screened for?
- A Celiac disease (gluten-sensitive enteropathy) ✓
- B Myasthenia gravis
- C Systemic lupus erythematosus
- D Autoimmune thyroiditis
Correct answer: A. Celiac disease (gluten-sensitive enteropathy)
Explanation
Dermatitis herpetiformis (Duhring's disease) has the pathognomonic DIF of granular IgA at dermal papillary tips and is invariably associated with gluten-sensitive enteropathy (celiac disease), even when the bowel disease is subclinical. Screening with anti-tissue transglutaminase IgA and duodenal biopsy is mandatory. A gluten-free diet improves both the skin and gut manifestations.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.