[Pseudopurpuric palmar localizations of herpetiform dermatitis]

We report an unusual manifestation of dermatitis herpetiformis in four patients. Three of them fulfill all the criteria for dermatitis herpetiformis: micro-abscesses of polymorphs in the upper papillary dermis, granular IgA deposit on IF examination, gluten-sensitive enteropathy, HLA B8. These peculiar lesions occur on palms and fingers, and appear as a petechial and ecchymotic purpura. A light painful sensation may precede the eruption. In two cases the palmar localisation initiated the course of the disease and remained isolated for more than one year. In only two cases, typical inflammatory lesions were associated on the palms. No lesions occurred on the soles. These peculiar palmar purpura-like lesions cleared with gluten-free diet or Dapsone therapy in the four patients.