Theoretical-practical approach to herpetiform dermatitis as the main cutaneous manifestation of celiac disease: An integrative review

Authors

DOI:

https://doi.org/10.33448/rsd-v10i6.15276

Keywords:

Herpertiformis dermatites; Celiac disease; Skin lesions; Versiculobullous lesions.

Abstract

Introduction: Dermatitis herpetiformis (DH) is a benign, chronic, inflammatory manifestation of the skin. The lesions are erythemato-papular vesicular eruptions, pruritic, symmetrical, herpetiform in shape, and have an affinity for extensor surfaces. It is male-dominant, between the ages of 30 and 40, and is related to abnormalities of the small intestinal mucosa and to IgA deposition in the papillary dermis. It has a multifactorial origin, encompassing genetic, environmental, and immunologic components. Objectives: To analyze the application of knowledge obtained by integrative review addressing dermatitis herpetiformis and celiac disease (CD) to develop a clinical rationale for early diagnosis and effective treatment. Methodology: Scientific and review articles published and referenced in MEDLINE, LILACS, IBECS, BINACIS, LIS, BRISA/RedTESA and MEdCArib were consulted, delimited from 2008 to 2019. The books "Tratado de dermatologia" by Belda Júnior and "Dermatologia" by Sampaio and Rivitti were also included. Results: The diagnosis of DH is clinical, laboratory and immunological. The presentation and eruption activity of the blisters is variable. The classic histopathologic finding is a subepidermal cleft with neutrophils and eosinophils in the dermal papillae, with perivesicular mixed inflammatory infiltrate. Direct immunofluorescence of uninvolved skin is the gold standard. The mainstay of treatment involves a gluten-free diet coupled with the use of medications.Incomplete remission is frequently observed in patients who do not restrict gluten. Conclusion: Knowledge of the clinical and subclinical manifestations of DH and CD as well as laboratory findings is crucial for early diagnosis, helping to rule out misdiagnosis, exacerbations, or complications.

Author Biography

Evandra Marielly Leite Nogueira Freitas Galvão , Centro Universitário UNINOVAFAPI

Graduated in MEDICINE from Faculdade Integral Diferencial (2010). Specialist in Dermatology by the Brazilian Society of Dermatology and the Brazilian Medical Association. Professor of the Discipline of Dermatology at the State University of Piauí and Centro Universitário Uninovafapi. Physician at the Municipal Health Foundation of Teresina. Operates in the field of Hansenology.

 

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Published

27/05/2021

How to Cite

HOLANDA, S. M. M. S. C. de .; NUNES , R. M. de O.; SILVA , L. A. dos S.; BARROS , M. M. de; SILVA , P. H. F.; ASSUNÇÃO , A. J. T.; MOURA , A. C.; GALVÃO , E. M. L. N. F. Theoretical-practical approach to herpetiform dermatitis as the main cutaneous manifestation of celiac disease: An integrative review. Research, Society and Development, [S. l.], v. 10, n. 6, p. e18110615276, 2021. DOI: 10.33448/rsd-v10i6.15276. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/15276. Acesso em: 5 nov. 2024.

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Section

Review Article