Dermatitis herpetiformis in Child
The cutaneous lesions seen in childhood are similar to those in adults, with symmetric papulovesicular eruption on the extensor surfaces and buttocks that is extremely pruritic and may wax and wane in severity. Facial involvement has been reported. Pruritus and nonpruritic, noninflammatory papules and pruritic purpuric macules / petechiae on the palms can be a rare presentation with or without the typical papulovesicular eruption.
About 80%-95% of children with DH have gluten-sensitive enteropathy on small intestine biopsy. Most are asymptomatic and undiagnosed at presentation of DH; only 10% of children carry a previous diagnosis of celiac disease.
There is an increased incidence of autoimmune diseases in patients with DH. The most common associated autoimmune conditions include thyroid dysfunction, particularly Hashimoto thyroiditis, type 1 diabetes mellitus, and pernicious anemia. Patients with DH are at an increased risk of developing enteropathy-associated T-cell lymphoma. However, a gluten-free diet may be protective against cancer development.
L13.0 – Dermatitis herpetiformis
111196000 – Dermatitis herpetiformis
Differential Diagnosis & Pitfalls
- Linear IgA bullous dermatosis of childhood
- Neurotic excoriations
- Papular urticaria
- Insect bite reactions
- Atopic dermatitis (eczematous dermatitis)
- Herpes simplex virus
- Epidermolysis bullosa simplex
- Chronic prurigo
- Polymorphous light eruption
- Pityriasis lichenoides et varioliformis acuta
- Prurigo pigmentosa
Drug Reaction Data