title: Acral purpura as leading clinical manifestation of dermatitis herpetiformis: report of two adult cases with a review of the literature.
abstract: Dermatitis herpetiformis (DH) is an autoimmune disease that clinically manifests as pruritic vesicles and papules. The diagnosis of DH is often challenging because of its wide spectrum of clinical presentations. We here report 2 patients with DH in whom finger petechiae represented the initial and leading manifestation of the disease, and the confirmed diagnosis critically relied on immunopathological studies. Therefore, besides the classic causes, clinicians should also consider DH in the differential diagnosis of acral purpura, even in patients only presenting with discrete acral petechial lesions. We also review the recent literature regarding the rare cases of petechiae in adult DH patients.
authors: Shanghai Skin Disease Hospital, Shanghai, China.
authors: Honggang
authors: H
authors: Tu
authors: Laurent
authors: L
authors: Parmentier
authors: Marco
authors: M
authors: Stieger
authors: Zoe
authors: Z
authors: Spanou
authors: Michael
authors: M
authors: Horn
authors: Helmut
authors: H
authors: Beltraminelli
authors: Luca
authors: L
authors: Borradori
mesh_terms: D000328:Adult; D001132:Arm; D001323:Autoantibodies / Q000097:blood; D001706:Biopsy; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis / Q000178:diet therapy; D003874:Dermatitis Herpetiformis / Q000150:complications* / Q000175:diagnosis*; D055050:Diet, Gluten-Free; D005385:Fingers; D019204:GTP-Binding Proteins; D005903:Gliadin / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis / Q000097:blood; D008297:Male; D008875:Middle Aged; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011693:Purpura / Q000209:etiology*; D012867:Skin / Q000737:chemistry / Q000473:pathology*; D011503:Transglutaminases / Q000276:immunology
chemical_list: D001323:Autoantibodies; D007070:Immunoglobulin A; D005903:Gliadin; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins