Dermatitis Herpetiformis

A 40-year-old man presented with tiny, intensely pruritic vesicles on the knees, legs, buttocks, elbows, and scalp. A skin biopsy confirmed the diagnosis of dermatitis herpetiformis.

The blisters are rarely seen because they are often excoriated, comment Drs Charles E. Crutchfield III and Eric J. Lewis of Minneapolis. Usually, vigorous scratching of the itchy eruptions leaves only crusts on the skin.

A strictly observed gluten-free diet may negate or lessen the need for drug treatment of dermatitis herpetiformis. Dapsone is the therapeutic agent of choice for this chronic disease and successfully managed the outbreak in this patient.