59 - Dermatitis Herpetiformis

Question 1

Dominant autoantigen in DH

Answer 1

Epidermal transglutaminase (eTG)

Question 2

Patients with DH have an associated _____ that is usually asymptomatic

Answer 2

Gluten-sensitive enteropathy (celiac disease)

Question 3

Usual distribution of DH lesions

Answer 3

Symmetric on the elbows, knees, buttocks, shoulders, sacral areas

Question 4

Significant increase in _____ and an occasional _____ in patients with DH, but no other increased risk of malignancy; other studies suggest that patients with DH may not have an increased risk of malignancy

Answer 4

Non-Hodgkin lymphomas

GI lymphoma

Question 5

Gluten is found in

Answer 5

Wheat
Barley
Rye

Question 6

DIF findings in DH

Answer 6

Granular dermal papillary deposits of IgA

Question 7

IgA1 is produced in the _____, whereas most IgA2 is produced at _____

Answer 7

Bone marrow

Mucosal sites

Question 8

Most vulnerable component of the DEJ junction

Answer 8

Lamina lucida

Question 9

DH blisters formation location

Answer 9

Within the lamina lucida

Question 10

More severe functional changes and clinical sequelae: enteropathy associated with DH vs celiac disease

Answer 10

Celiac disease

Question 11

With sulfones, symptoms may abate in as few as _____ or as long as a few days after the pill is taken, and new lesions no longer erupt after _____ of treatment

Answer 11

3 hours

1-2 days

Question 12

Preferred treatment for DH

Answer 12

Dapsone at an initial dosage of 100-150 mg/day

Question 13

Particularly useful in patients intolerant of dapsone, in elderly patients, and in those with cardiopulmonary problems

Answer 13

Sulfapyridine

Question 14

Complete resolution of the skin lesions of DH has been reported by adherence to the high-protein, unlimited fat, low-carbohydrate diet popularized as the

Answer 14

Atkins diet