Dermatitis herpetiformis pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pathophysiology[1]
Dermatitis herpetiformis is an autoimmune skin condition. The development of the rash is explained by genetic and environmental exposure.
Genetics
Dermatitis herpetiformis is found to be associated with the HLA DQ2 or HLA DQ8 alleles. The same alleles are found in patients with celiac disease, this explains the strong associated between celiac disease and dermatitis herpetiformis. The presence of these alleles in an individual presenting with symptoms of celiac disease or dermatitis herpetiformis has 100% negative predictive value.
Environment
Gluten in diet is the most significant in the development of the skin rash. Gluten consists of Gliadin and Gutenin, bother are peptides. Gliadin is the one which is responsible for the pathogenesis of the disease.
Immune response
The rash is developed due to the body's immune response which causes inflammatory reaction on the skin. The antibodies formed against the antigen ' Gliadin' and the presence of other autoantibodies like transglutaminases, the later are the most important in the pathogenesis of the disease.
References
- ↑ Clarindo MV, Possebon AT, Soligo EM, Uyeda H, Ruaro RT, Empinotti JC. Dermatitis herpetiformis: pathophysiology, clinical presentation, diagnosis and treatment. An Bras Dermatol. 2014;89(6):865-877. doi:10.1590/abd1806-4841.20142966