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Dermatitis Herpetiformis. Presented by D. N. Mac Vicar, MD, D. Cox, MD
A 6-year-old boy developed blisters on the shoulders seven weeks prior to examination. The eruption became increasingly pruritic and spread to involve ears, scalp, trunk, axillae, genitals, and legs, and some of the blisters became hemorrhagic and crusted. The lesions healed leaving hypopigmented areas. Recently, the child developed oral lesions. Findings from physical examination were normal. A skin biopsy specimen was suggestive of dermatitis herpetiformis. Immunofluorescence studies showed the presence of IgA but absence of IgG at the dermoepidermal junction.
Discussion
Dr. Raul Fleischmajer: Involvement of the scalp is common in the infantile form of dermatitis herpetiformis. What is the rationale for using vitamin E therapy?Dr. Donald R. Cox: The patient was given vitamin E for five days because, in the August 1973 Archives, some of the bullous diseases of childhood were reported to respond to this.