Dermatitis herpetiformis presenting as pseudovasculitis

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Presentation transcript:

Dermatitis herpetiformis presenting as pseudovasculitis Malan Kern, MD, Kevin H. Kim, MD, PhD, Gina Johnson, MD, Spencer D. Hawkins, MD, Henry K. Wong, MD, PhD  JAAD Case Reports  Volume 3, Issue 5, Pages 444-447 (September 2017) DOI: 10.1016/j.jdcr.2017.06.033 Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Well-demarcated distributed erythematous macules coalescing into larger patches with geographic borders on the upper back. JAAD Case Reports 2017 3, 444-447DOI: (10.1016/j.jdcr.2017.06.033) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Purpuric macules and patches in the periphery of erythematous patches on the anterior shins, knees, and thighs. JAAD Case Reports 2017 3, 444-447DOI: (10.1016/j.jdcr.2017.06.033) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Subepidermal blister with aggregates of neutrophils within the papillary dermal tips (arrow) with pronounced dermal hemorrhage but no evidence of leukocytoclastic vasculitis. (Hematoxylin-eosin stain; original magnification: ×200.) JAAD Case Reports 2017 3, 444-447DOI: (10.1016/j.jdcr.2017.06.033) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 Higher magnification highlights aggregates of neutrophils within the papillary dermal tips (arrow) and no evidence of leukocytoclastic vasculitis (arrow head). (Hematoxylin-eosin stain; original magnification: ×400.) JAAD Case Reports 2017 3, 444-447DOI: (10.1016/j.jdcr.2017.06.033) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 5 Direct immunofluorescence shows granular IgA deposition in the papillary dermal tips (arrow). (Original magnification: ×400.) JAAD Case Reports 2017 3, 444-447DOI: (10.1016/j.jdcr.2017.06.033) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions