Dermatitis herpetiformis

Case 146   Dec 2010 (P. McKee)  very early lesion showing papillary oedema.  Image too small to discern cellular detail 

Case 807  22.7.13  (M. Hurt)  M  24 itchy lesion arm 

Papillary oedema; one papilla shows leukocytoclasis without vasculitis.  IF +ve granular IgA. 

Case 844  11.9.13 (H. Diwan) F  61 elbow (*teaching)  

Classical.  IF confirmed. 

Case 999  22.4.14 (M. Hurt)  M 43 blister knee. 

Sub-epidermal blister with a few eos but also papillary tip microabscesses.   IF confusing.  Clinically it was DH. 

Case 1167  12.12.14 (R. Carr)  M 48 intensely itchy vesicles in typical DH sites 

I wondered about follicular CTCL, but everyone else thought pustular folliculitis.  Diagnosis of DH confirmed by IF.  Aberrant histology. 

Case 2590  10.6.20 (M. Abdel-Halim)  M 35  buttock (*teaching) 

Nice example 

Case 2781  4.3.21 (S. Taibjee) M 65 intensely itchy rash buttocks and elbows. Coeliac disease. 

Lymphocytic upper dermal infiltrate with prominent eosinophils.  Stratum corneum pustules.  Misleading initial impression of possible scabies.  Later images showed more typical papillary microabscesses.  Classical +ve granular IgA IF.  Occasionally DH can show prominent eosinophils. 

Case 2913  6.9.21 (M. Abdel-Halim)  F 50 grouped papulo-vesoicles elbows and hands (*teaching)   Classical.