Copyright ©2012 Baishideng. All rights reserved.
World J Dermatol. Oct 2, 2012; 1(3): 24-29
Published online Oct 2, 2012. doi: 10.5314/wjd.v1.i3.24
Dermatitis herpetiformis: Novel advances and hypotheses
Emiliano Antiga, Marzia Caproni, Paolo Fabbri
Emiliano Antiga, Marzia Caproni, Paolo Fabbri, Department of Critical Care, Section of Dermatology, University of Florence, 50129 Florence, Italy
Author contributions: All authors contributed to this paper.
Supported by Department of Planning Marshalling and Economic Deals, Ministry of Instruction, University and Research of the Italian Government
Correspondence to: Emiliano Antiga, MD, Department of Critical Care, Section of Dermatology, University of Florence; Piazza Indipendenza, 11, 50129 Florence, Italy.
Telephone: +39-55-6939664 Fax: +39-55-6939598
Received: June 22, 2012
Revised: September 25, 2012
Accepted: September 29, 2012
Published online: October 2, 2012

Dermatitis herpetiformis (DH) is a gluten-sensitive autoimmune blistering disorder with a chronic-relapsing course. Very recently, several Authors reported atypical cases of patients with DH, suggesting that different clinical subsets may exist at least among different ethnicities and that the classical picture of DH probably need a significant revision. Moreover, different pathogenetic aspects of the disease are currently under investigation, including the role of epidermal transglutaminase, apoptosis and inflammatory cells in the occurrence of skin lesions, in order to explain why only a subgroup of celiac patients will develop DH. Finally, although gluten-free diet is still regarded as the only curative approach to the disease, it is very hard to comply with and even small amounts of gluten can re-activate the disease. Therefore, different therapeutical approaches for the spectrum DH/celiac disease are still under investigation. In the present paper, the most recent advances in DH will be discussed, and a novel interpretation of the disease based on the data emerging from the Literature will be proposed.

Keywords: Dermatitis herpetiformis, Celiac disease, Transglutaminase, Gluten-free diet, Direct immunofluorescence