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Semergen 2004;30:279-85 - DOI: 10.1016/S1138-3593(04)74314-2
Dermatitis herpetiforme
J. Vergara Hernándeza,, , R. Díaz Peralb
a Médico de Familia. Centro de Salud Polígono Norte. Unidad Docente. Sevilla
b Médico Inspector. Unidad de Valoración Médica de Incapacidades. Sevilla
Recibido 29 junio 2001, Aceptado 26 enero 2004
Resumen

La dermatitis herpetiforme constituye una enfermedad crónica, hereditaria, de base inmune, que afecta preferentemente a la población del norte de Europa. Su frecuencia aproximada es de un caso por cada diez mil personas y predomina en varones con una relación de 1,5 a 1. Actualmente es considerada una forma de manifestación de la enfermedad celíaca, estando claramente demostrada la participación del gluten en el desarrollo de la misma. Clínicamente se caracteriza por lesiones cutáneas de tipo vesiculo-ampolloso, acompañadas de prurito intenso. Se ha puesto de manifiesto la elevación de los marcadores serológicos existentes en la enfermedad celíaca, aunque la única manera de establecer el diagnóstico definitivo es mediante la demostración de los depósitos granulares de inmunoglobulina A en la unión dermoepidérmica de piel sana o perilesional. En la totalidad de los casos está afectada la mucosa intestinal confirmándose mediante la realización de una biopsia duodenal. Aunque para el tratamiento sintomático se ha mostrado eficaz la dapsona, es fundamental el inicio de una dieta exenta de gluten para toda la vida.

Resumen

Dermatitis herpetiforme is a chronic, hereditary disease having an immune basis. It preferentially affects the Northern Europe population. Its approximate frequency is one case per every ten thousand persons and it predominates in males with a 1.5 to 1 ratio. At present, it is considered to be a manifestation form of celiac disease (CD), the participation of gluten being clearly demonstrated in its development. Clinically, it is characterized by vesicle-bullous type skin lesions, accompanied by intense itching. Increase of the serological markers existing in CD has been manifested, although the only way of establishing the definite diagnosis is by demonstration of granular IgA deposits in the dermoepidermic junction of healthy or perilesional skin. In all the cases, the intestinal mucosa is involved, which is verified by a duodenal biopsy. Although dapsone has been shown to be effective for symptomatic treatment, initiation of a gluten free diet for all one's life is essential.

Palabras clave
dermatosis ampollosa, dermatitis herpetiforme, intolerancia al gluten
Key words
bullous dermatosis, dermatitis herpetiforme, gluten intolerance
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Correspondencia: J. Vergara Hernández. Plaza de la Encarnación, 32. Portal 2,3°.B. 41003 Sevilla
Copyright © 2004. Elsevier España, S.L. y Sociedad Española de Medicina Rural y Generalista (SEMERGEN)