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Chronic plaque psoriasis is often associated with autoimmune bullous diseases. Dermatitis herpetiformis (DH) is a rare immunobullous disease that has been linked to celiac disease (CD). To our knowledge, the coexistence of psoriasis and DH is uncommon, and has only been described in anecdotal reports. We report a case of chronic plaque psoriasis co...
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... examination, he had multiple large, fixed, well-demarcated erythematous plaques on his back (Fig. 1) and typical features of nail psoriasis including onycholysis, pitting and splinter hemorrhages (Fig. 2). Of note, there were multiple vesicles present along the edges of the psoriatic plaques located on his back and hips (Fig. 3), as well as vesiculobullous eruptions on his fingers (Fig. 2). Histopathology of a vesicle taken from the ...
Citations
... Our extensive review of literature has revealed only a few case reports of co-existent dermatitis herpetiformis and psoriasis, with the latest report from Australia in 2021 [6][7][8]. A cross-sectional study by Woo et al. [4] has reported the presence of IgG and IgA anti-gliadin antibodies (AGA), IgA tTG antibodies, and IgA anti-endomysial antibodies (EMA) in more than 16% of patients with psoriasis and correlated with severe psoriatic disease activity. ...
... The patient in the present case had tense bullae present mainly over psoriatic plaques, an unusual presentation suggesting koebnerization of the DH lesions as a result of the epidermal inflammation yielded by psoriasis. In our case, there was a remarkable improvement in both psoriatic as well as DH lesions after administering dapsone, methotrexate, and a strict gluten-free diet, while in the case reported by Lee et al., [8] the patient did not have any significant improvement in psoriasis after gluten-free diet but responded to secukinumab. Other studies have also demonstrated improvements in psoriatic lesions in patients who followed a gluten-free diet with no additional pharmacologic treatment [16]. ...
Dermatitis herpetiformis (DH) is an auto-inflammatory skin disease that is linked to gluten sensitivity and is related to celiac disease (CD). Psoriasis is an inflammatory skin disorder found to have an association with the celiac disease, according to various genetic and epidemiological studies. We report a 12-year-girl who presented with multiple tense blisters along with red raised, scaly and itchy lesions over her body. She was a known case of psoriasis and was diagnosed as dermatitis herpetiformis in an immunofluorescence study. In this case report, we want to highlight the fact that the co-existence of dermatitis herpetiformis and psoriasis could be more than a mere coincidence. In our patient's previously uncontrolled psoriasis and dermatitis herpetiformis both improved after a gluten-free diet along with systemic therapy.
... The isomorphic response observed in our patient was attributed to the epidermal injury caused by the skin graft paired with the dermal inflammation caused by bumetanide. The diagnosis can be challenging, as it can mimic other vesiculobullous diseases including pemphigus vulgaris, bullous lichen planus, linear IgA bullous dermatosis, dermatitis herpetiformis, erythema multiforme, and Sweet's syndrome [3][4][5][6][7][8][9]. We provide an updated list of koebnerization in bullous diseases, along with the inciting dermatoses, which will be useful to the practicing physician ( Table 1). ...
Bullous pemphigoid (BP) can be a challenging diagnosis as it can mimic a variety of other inflammatory conditions. An isomorphic response may be seen in a variety of cutaneous diseases; however, there is a paucity of reports associated with BP. We present a case of recurrent drug-induced BP with an isomorphic response to trauma in a 73-year-old Caucasian male. Bumetanide was determined to be the inciting cause of the initial disease. The patient was initially treated with prednisone tapers and topical steroids. Mycophenolate Mofetil was eventually started after numerous flares. He later developed isomorphic bullous lesions at the periphery of a skin graft that was completed following a traumatic fall. He was started on clobetasol ointment with full resolution over the following month.
Dermatitis herpetiformis (DH) merupakan penyakit kulit autoimun kronik-residif akibat proses sekunder hipersensitivitas terhadap gluten. Kejadian DH tinggi pada populasi dengan predisposisi genetik HLA-DQ2 atau DQ8. Manifestasi klinis DH berupa lesi polimorfik ruam papulo-vesikular atau papul-eskoriasi didominasi rasa gatal. Baku emas diagnosis DH adalah pada pemeriksaan DIF didapatkan deposit imunoglobulin (Ig)-A granular di stratum papila dermis. Diet bebas gluten merupakan tata laksana utama. Dapson menjadi obat pilihan pertama. Prognosis baik dengan diagnosis dan tata laksana yang tepat. Dermatitis herpetiformis (DH) is a chronic-recurrent autoimmune skin disease caused by secondary hypersensitivity to gluten. The incidence of DH is high in population with genetic predisposition to HLA-DQ2 or DQ8. Clinical manifestations of DH are polymorphic lesions, papulo-vesicular rash or papules-excoriations, dominated by itching. The gold standard for diagnosis is the presence of granular immunoglobulin (Ig)-A deposits in the stratum papilla dermis on DIF examination. A gluten-free diet is the mainstay of treatment. Dapsone is the drug of choice. Prognosis is good with proper diagnosis and treatment.
p>Dermatitis herpetiformis (DH) merupakan penyakit kulit autoimun kronik-residif akibat proses sekunder hipersensitivitas terhadap gluten. Kejadian DH tinggi pada populasi dengan predisposisi genetik HLA-DQ2 atau DQ8. Manifestasi klinis DH berupa lesi polimorfik ruam papulo-vesikular atau papul-eskoriasi didominasi rasa gatal. Baku emas diagnosis DH adalah pada pemeriksaan DIF didapatkan deposit imunoglobulin (Ig)-A granular di stratum papila dermis. Diet bebas gluten
merupakan tata laksana utama. Dapson menjadi obat pilihan pertama. Prognosis baik dengan diagnosis dan tata laksana yang tepat.
Dermatitis herpetiformis (DH) is a chronic-recurrent autoimmune skin disease caused by secondary hypersensitivity to gluten. The incidence of DH is high in population with genetic predisposition to HLA-DQ2 or DQ8. Clinical manifestations of DH are polymorphic lesions, papulo-vesicular rash or papules-excoriations, dominated by itching. The gold standard for diagnosis is the presence of granular immunoglobulin (Ig)-A deposits in the stratum papilla dermis on DIF examination.
A gluten-free diet is the mainstay of treatment. Dapsone is the drug of choice. Prognosis is good with proper diagnosis and treatment. Prayogi Miura Susanto.
Diagnosis and Management of Dermatitis Herpetiformis</p
In orchestrating the wound healing process, the immune system plays a critical role. Hence, controlling the immune system to repair skin defects is an attractive approach. The highly complex immune system includes the coordinated actions of several immune cells, which can produce various inflammatory and antiinflammatory cytokines and affect the healing of skin wounds. This process can be optimized using biomaterials, bioactive molecules, and cell delivery. The present review discusses various immunomodulation strategies for supporting the healing of chronic wounds. In this regard, following the evolution of the immune system and its role in the wound healing mechanism, the interaction between the extracellular mechanism and immune cells for acceleration wound healing will be firstly investigated. Consequently, the immune‐based chronic wounds will be briefly examined and the mechanism of progression, and conventional methods of their treatment are evaluated. In the following, various biomaterials‐based immunomodulation strategies are introduced to stimulate and control the immune system to treat and regenerate skin defects. Other effective methods of controlling the immune system in wound healing which is the release of bioactive agents (such as antiinflammatory, antigens, and immunomodulators) and stem cell therapy at the site of injury are reviewed.
