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The first 25 slides, exactly as they appear. The full deck has 100 content slides.
Dermatology
Dermatitis Herpetiformis and Linear IgA Bullous Dermatosis
Built from Dermatology, 5th Edition
What’s inside
15 sections · 100 slides
Overview
- Scope of this topic
- How this topic is organised
- Four findings that support a diagnosis of DH
Dermatitis Herpetiformis: Introduction and History
A skin disease that is really the visible sign of gluten sensitivity
- What is dermatitis herpetiformis
- Course of dermatitis herpetiformis
- History of dermatitis herpetiformis
- Dermatitis herpetiformis: historic landmarks
- Dermatitis herpetiformis: historic landmarks (continued)
Dermatitis Herpetiformis: Epidemiology
Who gets DH, and how often
- Who gets dermatitis herpetiformis
- How common is dermatitis herpetiformis
Dermatitis Herpetiformis: Pathogenesis
How eating gluten ends up causing a blistering rash on the skin
- Key observations behind the DH mechanism
- Genetic predisposition in DH
- Gluten and the gut in DH
- From gluten to an immune attack: the first steps
- Proposed pathogenesis of dermatitis herpetiformis and celiac disease
- How a helper T cell response drives gut and antibody changes
- How gluten exposure leads to a skin blister
- Epitope spreading explains DH's timing
- Circulating antibodies in DH
- Evidence from animal models
- Granular IgA deposition: the hallmark of DH
- Iodide and DH flares
Dermatitis Herpetiformis: Associated Disorders
Other autoimmune diseases, and a cancer risk, linked to DH
- Thyroid disease and lymphoma risk in DH
- Other autoimmune disorders linked to DH
- Autoimmune disorders associated with dermatitis herpetiformis
Dermatitis Herpetiformis: Clinical Features
What DH looks like on the skin, and where it appears
- Distribution and lesion types in DH
- Less common presentations of DH
- Dermatitis herpetiformis on the elbow and knee
- Dermatitis herpetiformis on the back, buttocks, and fingertips
- Multiple pruritic papules with hemorrhagic crusts in DH
- Hemorrhagic macules on the thumb in DH
Dermatitis Herpetiformis: Pathology and IgA Deposits
What a biopsy shows, and why the biopsy site matters
- Routine histology in DH
- Dermatitis herpetiformis: histopathologic features
- Where to biopsy for the IgA stain in DH
- Direct immunofluorescence in dermatitis herpetiformis
- How often each IgA deposit pattern is seen in DH
Dermatitis Herpetiformis: Diagnosis
Blood tests, the diagnostic work-up, and diseases that mimic DH
- Laboratory evaluation in DH
- Approach to the patient with suspected dermatitis herpetiformis
- Differential diagnosis of DH
- DH, LABD, and bullous pemphigoid at a glance
- Characteristics that differentiate DH, LABD, and bullous pemphigoid
Dermatitis Herpetiformis: Treatment
Dapsone, its side effects, and the gluten-free diet
- Dapsone for DH: how it works and how fast
- Dapsone dosing in DH
- Facial disease and dapsone side effects overview
- Dapsone side effects: hemolysis
- Side effects of dapsone
- Side effects of dapsone
- Serious dapsone reactions to watch for
- Dapsone hypersensitivity syndrome and neuropathy
- Alternatives to dapsone in DH
- Monitoring patients on dapsone or sulfapyridine
- The gluten-free diet in DH
- Patient support for DH
Linear IgA Bullous Dermatosis: Introduction and History
A separate IgA disease, named for a straight line of antibody on the skin
- What is linear IgA bullous dermatosis
- The childhood form: chronic bullous disease of childhood
- Two structural types of LABD
- Two structural subtypes of LABD
- History of linear IgA bullous dermatosis
- Linking the childhood and adult forms at the molecular level
Linear IgA Bullous Dermatosis: Epidemiology and Pathogenesis
How common LABD is, and what its antibodies actually target
- Epidemiology of LABD
- BP180: the shared target of LABD and bullous pemphigoid
- BP180 fragments recognised by LABD antibodies
- Cleavage fragments of BPAG2/BP180 recognised in bullous pemphigoid and LABD
- The sublamina densa type of LABD
- Gut and other disease associations of LABD
- Malignancy and infection triggers of LABD
- Drug-induced LABD
- Drugs reported to cause LABD
- Drug-induced linear IgA bullous dermatosis
- Drug-induced linear IgA bullous dermatosis from vancomycin
Linear IgA Bullous Dermatosis: Clinical Features
A variable rash that can mimic either DH or bullous pemphigoid
- General clinical picture of LABD
- Chronic bullous disease of childhood
- LABD lesions resembling bullous pemphigoid
- Herpetiform, annular LABD lesions on an inflamed base
- Striking annular vesiculobullous lesions of LABD on the thigh
- Circumferential and linear vesicles and bullae in LABD
- Annular and herpetiform vesiculobullae on the face in childhood LABD
- Annular vesiculobullous lesions on the hands in LABD
- Annular and polycyclic plaques of the trunk in LABD
- Mucosal and drug-induced presentations of LABD
Linear IgA Bullous Dermatosis: Pathology and Diagnosis
Biopsy findings, and how LABD is separated from DH and bullous pemphigoid
- Pathology of LABD
- Linear IgA bullous dermatosis: histopathologic features
- Subtyping LABD by electron microscopy
- Direct immunofluorescence in linear IgA bullous dermatosis
- Separating LABD from DH and bullous pemphigoid
- Circulating antibodies and salt-split skin testing in LABD
Linear IgA Bullous Dermatosis: Treatment
Dapsone as first-line therapy, steroid-sparing options, and natural course
- First-line treatment of LABD
- Dosing in children and other treatment options
- Natural course of LABD
Summary
Bringing DH and LABD back together
- DH versus LABD: the core contrast
- Key takeaways
- References
- References (continued)
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- References (continued)
- Dermatology, 5th Edition (2-Volume Set)