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Leukocytoclastic vasculitis as the presenting feature of dermatitis herpetiformis.

Publication ,  Journal Article
Naylor, E; Atwater, A; Selim, MA; Hall, R; Puri, PK
Published in: Arch Dermatol
November 2011

BACKGROUND: Dermatitis herpetiformis is an autoimmune disease typically characterized by pruritic vesicles located on the extensor surfaces. Classic disease consists of neutrophils in the dermal papillae. Additional histopathologic findings include fibrin deposition and edema within the dermal papillae. Subepidermal vesicles also may be present. Direct immunofluorescence demonstrates granular IgA in the dermal papillae. OBSERVATIONS: A 58-year-old man with tender and pruritic erythematous macules and papules ranging from 2 to 6 mm in diameter had bilateral knee, elbow, forearm, scalp, and neck involvement. Petechiae also were present on the hands, thigh, knee, and ankle. A biopsy specimen initially demonstrated leukocytoclastic vasculitis. The results of workup for systemic vasculitis were negative. Subsequent biopsy specimens and direct immunofluorescence showed histologic evidence of dermatitis herpetiformis and leukocytoclastic vasculitis in the setting of an elevated serum IgA antitissue transglutaminase level. Marked improvement of the lesions was observed with a reduction of gluten in the patient's diet. CONCLUSIONS: Physicians should consider the possibility of dermatitis herpetiformis in patients with petechiae and leukocytoclastic vasculitis because leukocytoclastic vasculitis may be a prominent feature of dermatitis herpetiformis.

Duke Scholars

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Published In

Arch Dermatol

DOI

EISSN

1538-3652

Publication Date

November 2011

Volume

147

Issue

11

Start / End Page

1313 / 1316

Location

United States

Related Subject Headings

  • Vasculitis, Leukocytoclastic, Cutaneous
  • Transglutaminases
  • Middle Aged
  • Male
  • Immunoglobulin A
  • Humans
  • Fluorescent Antibody Technique, Direct
  • Diet, Gluten-Free
  • Dermatology & Venereal Diseases
  • Dermatitis Herpetiformis
 

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Naylor, E., Atwater, A., Selim, M. A., Hall, R., & Puri, P. K. (2011). Leukocytoclastic vasculitis as the presenting feature of dermatitis herpetiformis. Arch Dermatol, 147(11), 1313–1316. https://doi.org/10.1001/archdermatol.2011.293
Naylor, Elizabeth, Amber Atwater, M Angelica Selim, Russell Hall, and Puja K. Puri. “Leukocytoclastic vasculitis as the presenting feature of dermatitis herpetiformis.Arch Dermatol 147, no. 11 (November 2011): 1313–16. https://doi.org/10.1001/archdermatol.2011.293.
Naylor E, Atwater A, Selim MA, Hall R, Puri PK. Leukocytoclastic vasculitis as the presenting feature of dermatitis herpetiformis. Arch Dermatol. 2011 Nov;147(11):1313–6.
Naylor, Elizabeth, et al. “Leukocytoclastic vasculitis as the presenting feature of dermatitis herpetiformis.Arch Dermatol, vol. 147, no. 11, Nov. 2011, pp. 1313–16. Pubmed, doi:10.1001/archdermatol.2011.293.
Naylor E, Atwater A, Selim MA, Hall R, Puri PK. Leukocytoclastic vasculitis as the presenting feature of dermatitis herpetiformis. Arch Dermatol. 2011 Nov;147(11):1313–1316.

Published In

Arch Dermatol

DOI

EISSN

1538-3652

Publication Date

November 2011

Volume

147

Issue

11

Start / End Page

1313 / 1316

Location

United States

Related Subject Headings

  • Vasculitis, Leukocytoclastic, Cutaneous
  • Transglutaminases
  • Middle Aged
  • Male
  • Immunoglobulin A
  • Humans
  • Fluorescent Antibody Technique, Direct
  • Diet, Gluten-Free
  • Dermatology & Venereal Diseases
  • Dermatitis Herpetiformis