A 30 year old male presented with itchy, papulovesicular lesions in the extensor aspect of elbows and knees. Biopsy of the lesion showed dermoepidermal blister with micro-abscesses. Immunofluorescence showed deposits of IgA in the tips of dermal papillae. What is the MOST likely diagnosis?

Correct Answer: Dermatitis herpetiformis
Description: sensitive enteropathy. In this condition absorption of gluten induces the formation of circulating immune complexes which deposit in the dermal papillae causing inflammation and dermoepidermal split. Skin lesions are in the form of extremely itchy grouped papulovesicular lesions that develop on normal or erythematous skin. The most frequently involve the extensors(elbow, knee, buttocks, shoulder and sacral area). Biopsy shows: dermoepidermal blister with collection of polymorphs at the tip of dermal papillae. Immunofluorescence showed deposits of IgA in the tips of dermal papillae. Serology: Anti endomysial and anti reticulin antibodies are present in most patients. Ref: Illustrated Synopsis Of Dermatology & Sexually Transmitted Diseases (3Nd By Khanna page 71.
Category: Skin
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