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Coeliac disease presenting as dermatitis herpetiformis in infancy

Daniel Lemberg1, Andrew S Day, Timothy Bohane

  • 1Department of Gastroenterology, Sydney Children's Hospital, New South Wales, Australia.

Journal of Paediatrics and Child Health
|June 15, 2005
PubMed

Insights

Dermatitis herpetiformis (DH), a gluten-sensitive condition, is increasingly diagnosed in children with coeliac disease (CD). This case highlights DH as a rare, early sign in infants, even presenting before typical CD symptoms.

Area of Science:

  • Pediatrics
  • Gastroenterology
  • Dermatology

Background:

  • Coeliac disease (CD) diagnosis in children is rising due to improved screening.
  • Gluten-sensitive enteropathy awareness is increasing, alongside associated disorders.
  • Dermatitis herpetiformis (DH) is the most frequent CD-associated skin condition.

Observation:

  • An 8-month-old infant presented with itchy skin lesions, diagnosed as DH.
  • This infant represents the youngest reported case of DH as an initial sign of gluten-sensitive disease since 1966.
  • The presentation occurred before other typical signs of coeliac disease were evident.

Findings:

  • Dermatitis herpetiformis can be the primary manifestation of gluten-sensitive enteropathy in infants.
  • Early recognition of DH is crucial for timely coeliac disease diagnosis in pediatric cases.
  • This case underscores the importance of considering DH in infants with unexplained chronic rashes.

Implications:

  • Highlights the need for heightened clinical suspicion for coeliac disease in infants with dermatitis herpetiformis.
  • Suggests that paediatricians and dermatologists should consider gluten-sensitivity in infants presenting with atypical rashes.
  • Emphasizes the diagnostic value of DH in identifying gluten-sensitive enteropathy in very young children.

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