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Case Reports
. 2021 Feb 24;13(1):141-147.
doi: 10.1159/000512870. eCollection 2021 Jan-Apr.

Development of Dermatitis Herpetiformis in Chronic Plaque Psoriasis

Ruby Lee  1 , Yolanka Lobo  1 , Lynda Spelman  1   2
Affiliations
Case Reports

Development of Dermatitis Herpetiformis in Chronic Plaque Psoriasis

Ruby Lee et al. Case Rep Dermatol. .

Abstract

Chronic plaque psoriasis is often associated with autoimmune bullous diseases. Dermatitis herpetiformis (DH) is a rare immunobullous disease that has been linked to celiac disease (CD). To our knowledge, the coexistence of psoriasis and DH is uncommon, and has only been described in anecdotal reports. We report a case of chronic plaque psoriasis complicated by DH in a 60-year-old patient with no known history of CD or associated symptoms. In our patient, DH presented atypically as multiple vesicles along the edges of psoriatic plaques located on the back and hips, and as vesiculobullous eruptions on the fingers. The patient was successfully treated with a combination of dapsone and a gluten-free diet for DH, and secukinumab for psoriasis. This case highlights the importance of screening for CD in patients with psoriasis, as well as other concomitant autoimmune diseases. A gluten-free diet should be trialled in psoriatic patients with positive CD serology.

Keywords: Celiac disease; Dermatitis herpetiformis; Psoriasis.

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Conflict of interest statement

The authors have no conflicts of interest to declare with respect to the research and/or authorship of this case report.

Figures

Fig. 1
Fig. 1
Chronic plaque psoriasis on the lower back.
Fig. 2
Fig. 2
Characteristic features of nail psoriasis are seen, with onycholysis, pitting and splinter hemorrhages. In addition, dermatitis herpetiformis presents atypically as vesiculobullous eruptions on the fingers.
Fig. 3
Fig. 3
Dermatitis herpetiformis presenting as multiple vesicles on the edges of psoriatic plaques located on the back.
See this image and copyright information in PMC

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