A 35-year-old patient presents with intensely pruritic, grouped vesicles on the elbows and buttocks. DIF of perilesional skin shows granular IgA deposits at the dermal papillae. The most sensitive serological marker for the associated systemic disease is:

• A Anti-endomysial IgA antibodies
• B Anti-epidermal transglutaminase (anti-eTG) IgA ✓
• C Anti-tissue transglutaminase (anti-tTG) IgA
• D Anti-Dsg1 IgA antibodies

Explanation

Dermatitis herpetiformis (DH) is the described condition, associated with gluten-sensitive enteropathy (celiac disease). Anti-epidermal transglutaminase (anti-eTG/anti-TG3) IgA is the most sensitive and specific serological marker directly for DH itself. Anti-tTG IgA is sensitive for celiac disease but less specific for DH skin disease. The granular IgA at dermal papillae on DIF is pathognomonic of DH and is the gold standard for diagnosis.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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