Case Number : Case 807 - 22nd July Posted By: Guest

DH

Agree, dermatitis herpetiformis

Agree with Dr Engin and Dr Romualdo.
Because Dr Mark like acronyms and mnemonics , I am mentioning this;
PLAID
(for conditions withsubepidermal split, andneutrophils stuffed in dermal papillae)
P
emphigoid (bullous)
L
upus (bullous SLE)
A
cquista (Epidermolysis Bullosa Acquista)
I
gA, linear
D
ermatitis herpetiformis

Agree with Dr Engin and Dr Romualdo.
Because Dr Mark like acronyms and mnemonics , I am mentioning this;
PLAID
(for conditions withsubepidermal split, andneutrophils stuffed in dermal papillae)
P
emphigoid (bullous)
L
upus (bullous SLE)
A
cquista (Epidermolysis Bullosa Acquista)
I
gA, linear
D
ermatitis herpetiformis

Dermatitis herpetiformis

[font="Palatino Linotype, serif"][size="4"]Edematous papillary dermis, infiltrate of neutrophils and nuclear dust at the tip of a dermal papilla that displays a draft of a subepidermal cleft.[/size][/font]
[font="Palatino Linotype, serif"][size="4"]On microscopic examination alone it is not possible to distinguish unequivocally between early dermatitis herpetiformis and early linear IgA dermatosis, but after a case history of lesions on an extremity of a young adult I'll favor the former hypothesis.[/size][/font]
[font="Palatino Linotype, serif"][size="4"]Another differential diagnosis is bullous lupus erythematosus, but no increased mucin can be found in the reticular dermis.[/size][/font]

Agree, Dermatitis herpetiformis.

Agree with Maria's differential, favor DH.
Superficial and deep perivascular lymphocytic dermatitis with neutrophils and lesser numbers of eosinophils. Some leukocytoclastic debris without vasculitis. Diffuse papillary dermal edema. Neutrophils, mild spongiosis in a psoriasiform epidermis. No adnexal involvement, no evidence of bug bite or tinea in the epidermis.

[color=#000000][font=verdana, arial, Helvetica, sans-serif][size=3]Dermatitis herpetiformis pattern (assuming other Ig results are negative):[/size][/font][/color]
[color=#000000][font=verdana, arial, Helvetica, sans-serif][size=3]Granular IgA deposits at the junction, concentrated in the dermal papillae.[/size][/font][/color]

Granular deposits of IgA in the dermal papillae at direct immunofluorescence are characteristic of dermatitis herpetiformis.

Lovely, agree with DH

Dermatitis herpetiformis.