A 30-year-old man presents with intensely pruritic, grouped vesicles over extensor surfaces of elbows, knees, and buttocks. He also has celiac disease. DIF of perilesional skin shows granular IgA deposits at the papillary dermis. What is the diagnosis?
- A Dermatitis herpetiformis ✓
- B Bullous pemphigoid
- C Linear IgA bullous dermatosis
- D Herpes gestationis
Correct answer: A. Dermatitis herpetiformis
Explanation
Dermatitis herpetiformis (DH) is an autoimmune bullous disorder associated with gluten-sensitive enteropathy (celiac disease). It presents with intensely pruritic grouped vesicles on extensor surfaces, and the diagnostic hallmark on DIF is granular IgA deposits in the dermal papillae of perilesional skin, which distinguishes it from linear IgA disease. Anti-tissue transglutaminase and anti-endomysial antibodies are positive, and the condition responds dramatically to dapsone and a gluten-free diet.
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.