title: Dermatitis herpetiformis presenting as digital petechiae.
abstract: We present a 15-year-old female patient with a 6-month history of recurrent painful petechiae on the fingers and feet. Trauma or pressure were denied, but she reported recurrent tonsillitis and urinary tract infections and a single event of bilateral scotoma. Extensive investigations (e.g., echocardiography) for a suspected diagnosis of septic emboli were unremarkable. Routine histopathology, direct and indirect immunofluorescence, and esophagogastroduodenoscopy led to the diagnosis of dermatitis herpetiformis. The therapeutic strategy comprised gluten-free diet and dapsone to alleviate the symptoms. Dermatitis herpetiformis should be included in the differential diagnosis of palmar or plantar petechiae, especially when occurring in children or young adults.
authors.affiliation: Department of Dermatology, University Hospital Regensburg, Regensburg, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Heinlin
authors.forename: Birgit
authors.initials: B
authors.lastname: Knoppke
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kohl
authors.forename: Michael
authors.initials: M
authors.lastname: Landthaler
authors.forename: Sigrid
authors.initials: S
authors.lastname: Karrer
mesh_terms: D000293:Adolescent; D002446:Celiac Disease / Q000175:diagnosis* / Q000178:diet therapy / Q000188:drug therapy; D003622:Dapsone / Q000627:therapeutic use; D003874:Dermatitis Herpetiformis / Q000175:diagnosis* / Q000178:diet therapy / Q000188:drug therapy; D055050:Diet, Gluten-Free; D005260:Female; D005385:Fingers / Q000473:pathology; D005493:Folic Acid Antagonists / Q000627:therapeutic use; D006801:Humans; D011693:Purpura / Q000175:diagnosis* / Q000178:diet therapy / Q000188:drug therapy
chemical_list: D005493:Folic Acid Antagonists; D003622:Dapsone