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Dermatitis herpetiformis presenting as chronic urticaria.
Gavin R Powell1, Anna L Bruckner, William L Weston
1Department of Dermatology, University of Colorado Health Sciences Center, Aurora, Colorado 80045-0510, USA.
Pediatric Dermatology
|October 6, 2004
Summary
Childhood dermatitis herpetiformis (DH), a rare skin condition, can present unusually as chronic urticaria-like lesions in children. Early diagnosis via skin biopsy and immunofluorescence is crucial for effective treatment.
Area of Science:
- Immunodermatology
- Pediatric Dermatology
Background:
- Childhood dermatitis herpetiformis (DH) is a rare immunobullous disease linked to gluten-sensitive enteropathy.
- It typically manifests as intensely pruritic vesicles on extensor surfaces.
Observation:
- An 11-year-old boy presented with a 7-month history of chronic, urticaria-like skin lesions.
- These lesions were unresponsive to standard urticaria treatments and appeared as evanescent wheals on the trunk, face, and extremities.
Findings:
- Skin biopsy and direct immunofluorescence of perilesional skin confirmed dermatitis herpetiformis (DH).
- The patient initially lacked symptoms of gluten-sensitive enteropathy but responded rapidly to dapsone therapy.
Implications:
- This case highlights an atypical presentation of childhood DH, emphasizing the need to consider it in pediatric chronic urticarial cases.
- Diagnostic vigilance is essential, even without typical enteropathy symptoms, for prompt and effective management.