A 28-year-old man presents with intensely pruritic grouped vesicles on the elbows, knees, buttocks, and scalp. DIF of perilesional skin reveals granular IgA deposits at dermal papillary tips. Which associated condition should be screened for?

• A Ulcerative colitis
• B Primary biliary cirrhosis
• C Celiac disease (gluten-sensitive enteropathy) ✓
• D Myasthenia gravis

Explanation

Dermatitis herpetiformis (DH) shows granular IgA at papillary dermis tips on DIF — pathognomonic finding. Nearly all patients (>90%) have celiac disease (gluten-sensitive enteropathy), often subclinical. Anti-endomysial and anti-tissue transglutaminase (anti-tTG) IgA antibodies are positive. Gluten-free diet controls both the gut disease and skin lesions. The other conditions listed are not specifically associated.

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.