A Rare Case of Dermatitis Herpetiformis Presenting as Fingertip Petechiae

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Amy Weiss
Shiri Nawrocki
Ana Cristina Laureano
Sharon Scherl
Kenneth Shulman
Eun Ji Kwon


dermatitis herpetiformis, celiac disease, gluten-sensitive enteropathy, autoimmune disease, direct immunofluorescence.


Dermatitis herpetiformis (DH) is an uncommon inflammatory autoimmune disease that most commonly presents as a pruritic, papulovesicular eruption in young children and adolescents. It follows a chronic and relapsing course and usually involves extensor surfaces of the elbows, forearms, buttocks, and knees and can also involve the scalp. DH is usually accompanied by gluten-sensitive enteropathy (celiac disease). In most patients with DH, the enteropathy is asymptomatic. DH is usually a life-long condition that requires continued treatment, including dapsoneand elimination of gluten from the diet. We describe a rare case of a patient who presented with fingertip petechiae as the only initial manifestation of DH. DH should be considered in the differential diagnosis of petechiae of the fingertips, even if it is the only presenting sign.


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