During’s herpetiform dermatitis in pediatric dermatology: issues of diagnostics and treatment

This article presents a case of clinical observation of a 5-year-old child with herpetiformis dermatitis (Duhring’s). This rare dermatosis is characterized by a chronic relapsing course, the presence of itching polymorphic rashes, typical histological and immunomorphological signs. The diagnosis was made on the basis of the clinical picture, histological and immunohistochemical studies of skin biopsy, as well as the results of HLA typing by PCR. Clinical observation of this case is of interest to practicing physicians-dermatologists due to the rare occurrence of Duhring’s herpetiformis in children, the complexity of differential diagnostic search, which requires further generalization of experience using histological, immunohistochemical and molecular genetic research methods. The disease is clearly differentiated from other rashes with the formation of subepidermal blisters according to histological, immunological and gastrointestinal criteria. The prevalence of dermatosis in various populations of the Europian race ranges from 10 to 39 cases per 100,000 population. Duhring’s dermatitis herpetiformis can develop at any age (cases of the childhood form of Duhring’s dermatitis herpetiformis have been reported), but most often the disease occurs at the age of 40–50 years. Dermatitis herpetiformis persists indefinitely with variable severity. In patients with Duhring’s dermatitis, associated gluten-sensitive enteropathy is often noted, which in most cases is asymptomatic.