Guidelines for the management of dermatitis herpetiformis

Dermatitis herpetiformis is a rare autoimmune bullous disorder characterized by intensely pruritic polymorphic lesions over extensor surfaces of body, associated with gluten sensitive subclinical or clinical enteropathy. Dermatitis herpetiformis is often misdiagnosed and there is a paucity of guidelines for the management of dermatitis herpetiformis in literature. The present guidelines have been prepared for physician and dermatologists. It reflects highest evidence based data available at the time of formulating the guidelines. The diagnosis of dermatitis herpetiformis is made clinically, histologically, immunopathologically and supported by serology. A gluten free diet is the treatment of choice for all patients with dermatitis herpetiformis. Dapsone should be used during the acute presentation until the gluten free diet is effective. In conclusion, the present guidelines provide evidence based guidance for management of dermatitis herpetiformis.