Small bowel (small intestine) - Dermatitis herpetiformis

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Small bowel (small intestine)

Malabsorption

Dermatitis herpetiformis

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 14 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

See also Skin-nontumor chapter

General
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● Usually present with skin manifestations only and are not aware of the underlying small-bowel problems ● Resembles celiac sprue - both respond to gluten free diet (skin lesions improve), both associated with HLA-B8 and HLA-DR3, both associated with lymphoma
● Pruritic, papulovesicular lesions symmetrically distributed on scalp, buttocks, extremities, with granular deposition of IgG at epidermal-dermal junctional
● Diagnosis: circulating IgA antibodies against epidermal transglutaminase (eTG) and tissue transglutaminase (tTG) (J Invest Dermatol 2008;128:332, J Am Acad Dermatol 2009;61:39)

Micro description
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● Severe mucosal lesion on small bowel biopsy
● May be patchy with variable villus abnormality

End of Small bowel (small intestine) > Malabsorption > Dermatitis herpetiformis

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