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Brief Report
March 2017

Rituximab Treatment for Recalcitrant Dermatitis Herpetiformis

Author Affiliations
  • 1Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
  • 2Department of Dermatology, University of Utah School of Medicine, Salt Lake City
 

Copyright 2016 American Medical Association. All Rights Reserved.

JAMA Dermatol. 2017;153(3):315-318. doi:10.1001/jamadermatol.2016.4676
Abstract

Importance  Dermatitis herpetiformis (DH) is an autoimmune blistering condition seen in the context of celiac disease. While typically managed by gluten-free diet and dapsone, treatment of DH refractory to standard treatments is not well defined.

Observations  A man in his 80s with DH not controlled by gluten-free diet (with poor adherence), dapsone, and conventional immune-suppressing agents responded to treatment with rituximab according to the lymphoma protocol (4 weekly infusions of 375 mg/m2). Thirteen months after treatment, the patient had achieved complete resolution of pruritus and clinical manifestations of the disease, as well as normalization of antibodies against epidermal and tissue transglutaminases. He achieved complete clinical and serological remission and has remained symptom-free up to 18 months following treatment.

Conclusions and Relevance  We present here the first case of a patient with DH treated with rituximab who achieved complete clinical and serological remission. We suggest rituximab as a viable treatment option for recalcitrant DH.

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