A Rare Case of Dermatitis Herpetiformis Presenting as Fingertip Petechiae
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.
Tu H, Parmentier L, Stieger M, et al. Acral purpura as leading clinical manifestation of dermatitis herpetiformis: report of two adult cases with a review of the literature. Dermatology. 2013;227(1):1-4.
Zaghi D, Witheiler D, Menter AM. Petechial eruption on fingers. Dermatitis herpetiformis. JAMA dermatology. 2014;150(12):1353-1354.
Flann S, Degiovanni C, Derrick EK, Munn SE. Two cases of palmar petechiae as a presentation of dermatitis herpetiformis. Clin Exp Dermatol. 2010;35(2):206-208.
Hofmann SC, Nashan D, Bruckner-Tuderman L. Petechiae on the fingertips as presenting symptom of dermatitis herpetiformis Duhring. J Eur Acad Dermatol Venereol. 2009;23(6):732-733.
Lopez Aventin D, Ilzarbe L, Herrero-Gonzalez JE. Recurrent digital petechiae and weight loss in a young adult. Gastroenterology. 2013;144(7):e10-11.
Perez-Garcia MP, Mateu-Puchades A, Soriano-Sarrio MP. A 26-year-old woman with palmar petechiae. Int J Dermatol. 2013;52(12):1493-1494.
Bonciolini V, Bonciani D, Verdelli A, et al. Newly described clinical and immunopathological feature of dermatitis herpetiformis. Clin Dev Immunol. 2012;2012:967974.
McGovern TW, Bennion SD. Palmar purpura: an atypical presentation of childhood dermatitis herpetiformis. Pediatr Dermatol. 1994;11(4):319-322.
Pierce DK, Purcell SM, Spielvogel RL. Purpuric papules and vesicles of the palms in dermatitis herpetiformis. J Am Acad Dermatol. 1987;16(6):1274-1276.
Massone L, Borghi S, Pestarino A, Piccini R, Gambini C. Dermatitis herpetiformis: a case with palmar purpuric lesions treated with disodium cromoglycate. J Am Acad Dermatol. 1988;19(3):577.
Naylor E, Atwater A, Selim MA, Hall R, Puri PK. Leukocytoclastic vasculitis as the presenting feature of dermatitis herpetiformis. Arch Dermatol. 2011;147(11):1313-1316.
Setty M, Hormaza L, Guandalini S. Celiac disease: risk assessment, diagnosis, and monitoring. Mol Diagn Ther. 2008;12(5):289-298.
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