178 Dermatitis herpetiformis Instruction Look at this patient’s skin, who in the past had chronic diarrhoea. Salient features History • History of diarrhoea • History of gluten intolerance (although these patients rarely have gross malabsorption) • Ask the patient whether the rash itches. Examination • Dry, itchy vesicles and urticarial plaques (Fig. 178.1) occurring bilaterally and symmetrically over the extensor surfaces, elbows, knees, posterior neck, back and buttocks. Fig. 178.1 Dermatitis herpetiformis. (A) Pruritic, urticarial papules and small blisters. (B) Occurrence in the lumbosacral area. (With permission from Habif 2009.) Proceed as follows: • Look for similar lesions on the scalp, face, neck, shoulders, buttocks, knees and calves. Diagnosis This patient has itchy vesicles on the elbows (lesion) caused by dermatitis herpetiformis (functional status). Advanced-level questions From which other itchy skin disorder should dermatitis herpetiformis be differentiated? Scabies. What are the extracutaenous manifestations of dermatitis herpetiformis? • Gluten-sensitive enteropathy (frequent, asymptomatic) • Thyroid dysfunction (especially hypothyroidism) • Lymphoma (especially GI). Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Like this:Like Loading... Related Related posts: Permanent cardiac pacemaker/implantable cardioverter-defibrillator Cauda equina syndrome Dermatomyositis Arteriovenous fistula Stay updated, free articles. Join our Telegram channel Join Tags: 250 Cases in Clinical Medicine Dec 4, 2016 | Posted by admin in GENERAL & FAMILY MEDICINE | Comments Off on Dermatitis herpetiformis Full access? Get Clinical Tree
178 Dermatitis herpetiformis Instruction Look at this patient’s skin, who in the past had chronic diarrhoea. Salient features History • History of diarrhoea • History of gluten intolerance (although these patients rarely have gross malabsorption) • Ask the patient whether the rash itches. Examination • Dry, itchy vesicles and urticarial plaques (Fig. 178.1) occurring bilaterally and symmetrically over the extensor surfaces, elbows, knees, posterior neck, back and buttocks. Fig. 178.1 Dermatitis herpetiformis. (A) Pruritic, urticarial papules and small blisters. (B) Occurrence in the lumbosacral area. (With permission from Habif 2009.) Proceed as follows: • Look for similar lesions on the scalp, face, neck, shoulders, buttocks, knees and calves. Diagnosis This patient has itchy vesicles on the elbows (lesion) caused by dermatitis herpetiformis (functional status). Advanced-level questions From which other itchy skin disorder should dermatitis herpetiformis be differentiated? Scabies. What are the extracutaenous manifestations of dermatitis herpetiformis? • Gluten-sensitive enteropathy (frequent, asymptomatic) • Thyroid dysfunction (especially hypothyroidism) • Lymphoma (especially GI). Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Like this:Like Loading... Related Related posts: Permanent cardiac pacemaker/implantable cardioverter-defibrillator Cauda equina syndrome Dermatomyositis Arteriovenous fistula Stay updated, free articles. Join our Telegram channel Join Tags: 250 Cases in Clinical Medicine Dec 4, 2016 | Posted by admin in GENERAL & FAMILY MEDICINE | Comments Off on Dermatitis herpetiformis Full access? Get Clinical Tree
