All are true about Dermatitis herpetiformis EXCEPT:: (A) The lesions are intensely itchy, (B) Lesions have epidermal bullae, (C) IgA in Papillary tips, (D) Associated with gluten enteropathy
Answer is B. Lesions have epidermal bullae REF: Fitzpatrik dermatology 6th ed p. 558-73 Dermatitis herpetiformis (DH) is an intensely pruritic, papulovesicular skin disease characterized by lesions symmetrically distributed over extensor surfaces (i.e., elbows, knees, buttocks, back, scalp, and posterior neck). Almost all DH patients have an associated, usually subclinical, gluten-sensitive enteropathy , and >90% express the HLA-B8/DRw3 and HLA-DQw2 haplotypes. DH may present at any age, including childhood; onset in the second to fouh decades is most common. The disease is typically chronic. Biopsy: Small intestine shows paial villus atrophy Skin lesions show sub-epidermal bullae and papillary tip abscess , IgA in papillary tips (on DIF) Treatment: Dapsone and gluten free diet