Gjersvik Petter Jensen, Rønnevig Jørgen R
Tidsskrift for Den norske laegeforening, Postboks 1152 Sentrum, 0107 Oslo.
Tidsskr Nor Laegeforen. 2003 Nov 20;123(22):3234-6.
Dermatitis herpetiformis is characterised by an intensely itchy, chronic, papulovesicular eruption, usually on elbows, knees and buttocks. The diagnosis is based on granular IgA deposits in the dermal papillae in a perilesional skin biopsy analysed by immunofluorescence microscopy. Most patients have subclinical celiac disease; a gluten-free diet is effective in most cases. IgA antibodies against tissue transglutaminase (TG2) may be involved in the pathogenesis of celiac disease with or without dermatitis herpetiformis, and an epidermal transglutaminase (TG3) may be the autoantigen in dermatitis herpetiformis. This article provides a short review intended for the general practitioner of the pathogenesis, diagnosis and treatment of dermatitis herpetiformis.
疱疹样皮炎的特征是剧烈瘙痒的慢性丘疹水疱性皮疹,通常出现在肘部、膝盖和臀部。诊断基于通过免疫荧光显微镜分析的病损周围皮肤活检中真皮乳头内的颗粒状IgA沉积。大多数患者患有亚临床乳糜泻;无麸质饮食在大多数情况下有效。抗组织转谷氨酰胺酶(TG2)的IgA抗体可能参与有或无疱疹样皮炎的乳糜泻的发病机制,而表皮转谷氨酰胺酶(TG3)可能是疱疹样皮炎中的自身抗原。本文为全科医生提供了一篇关于疱疹样皮炎发病机制、诊断和治疗的简短综述。