Dermatitis Herpetiformis In Childhood

Dermatitis herpetiformis skin rash. Courtesy Wikimedia

What Is Dermatitis Herpetiformis In Childhood?

Dermatitis herpetiformis in childhood is an inflammatory skin manifestation of celiac disease in which immunoglobulin A (IgA) autoantibodies target components of the skin, leading to blister formation caused by ingestion of gluten in the diet.  

Dermatitis herpetiformis is characterized by multiple intensely itchy, red blisters appearing on the elbows which can extend down the forearm to the wrist and the back of the knees. Less usual areas involve the back, buttocks, scalp, and abdomen. 

Q: Do the blisters leave a mark when healed?

A: Crops of skin eruptions begin with itching or a burning sensation in reddened papules. There are grouped vesicles and tense blisters. The blister contents may be serous or bloody, with symmetrical distribution (eg, both knees or both elbows). Fluid filled elements rupture leaving denuded areas of sore skin and crust. Subsequently, there is residual hypopigmentation (a white area) or hyperpigmentation (dark area).1

Most conditions in the spectrum of autoimmune blistering disorders are uncommonly seen in the pediatric population, even the most common ones, such as dermatitis herpetiformis.2 The true incidence  is unknown. 

What Is Dermatitis Herpetiformis In Childhood In Celiac Disease and/or Gluten Sensitivity?

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1. Mendes FB, Hissa-Elian A, de Abreu MA, Gonçalves VS. Review: dermatitis herpetiformis. An Bras Dermatol. 2013 Jul-Aug;88(4):594-9. [↩]
2. Lara-Corrales I1, Pope E. Autoimmune blistering diseases in children. Semin Cutan Med Surg. 2010 Jun;29(2):85-91. doi: 10.1016/j.sder.2010.03.005. [↩]