Dermatitis Herpetiformis: Clinical Exploration, Underlying Pathogenesis and Therapeutic Advances
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Abstract
Dermatitis herpetiformis (DH) emerges as a chronic, immune-mediated, systemic skin pathology closely linked to celiac disease (CD). Characterized by polymorphous and pruritic cutaneous manifestations, DH presents a unique clinical and diagnostic challenge. In this article, we seek to comprehensively delineate the clinical, histologic, and immunologic dimensions of DH, with particular emphasis on its etiopathogenic association with CD. The underlying autoimmune cascade involving the interaction between immunoglobulin A (IgA) and tissue transglutaminase is examined, with crucial implications in the pathogenesis of DH.
As understanding of immunologic mechanisms expands, the diverse spectrum of clinical presentations of DH is explored, highlighting the variability in skin lesion morphology and its correlation with histologic findings. In the therapeutic arena, conventional and emerging approaches are reviewed, ranging from dapsone-based drug therapy to nutritional and pharmacologic interventions aimed at suppressing the abnormal immune response. As research advances, it is essential to further the early diagnosis and integrated management of DH, addressing both cutaneous symptoms and systemic implications, to improve patients' quality of life and provide comprehensive and insightful clinical care.
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