25 years female Multiple vesicular lesions on the back throughout the body sine 8 months Burning and itching No fever No extramarital contact Her husband have bad contacts.



Multiple pimples filled lesions with tense bullae on the body with pain and itching more favour to DERMATITIS HERPETIFORMIS. Diagnosed by skin biopsy Treatment : Gluten free diet Long standing ise of dapsone will give treatment .

DH (Dermatitis Herpetiformis) Extremely itchy,grouped papulovesicular lesions,rapidly excoriated, repeated scratching may cause eczematous changes and secondary infection are suggestive. Gluten sensitivity enteropathy may be there. Adv skin biopsy for confirmation . Dapsone is used as therapeutic test for DH.

Dermatitis herpetiformis Vesicles over margin of lesions and if intense itching are typical Dapsone drug of choice if patient's G6PD activity is normal one can comfirm by taking biopsy of intact vesicle that is new less than of 24 hours. .

I agree with Dr S Patel

To r/o Duhring's Dermatitis jadassohn's patch test can be performed using 50% KI on unaffected skin. If patient is not on treatment or gluten free diet, then test results are reliable. The typical locations like lateral surface of neck, elbow and knee jt surface and gluteal regions are first to be affected very often. So history of evolution of clinical picture might also help reach a diagnosis. The annular patterns of lesions at places is very likely of some IgA dermatosis, so Duhring is a good bet as mentioned by Doctors already hear. Strict gluten free diet is cardinal to stay away from long standing use of dapsone and burden of its side effects.

The bulla on the left shoulder appears to be tense and there are urticarial wheals, excoriations. D/D's : bullous pemphigoid, dermatitis herpetiformis. Oral mucosal involvement Sir? Tzanck Smear, Biopsy, DIF would confirm the diagnosis.

Dermatitis herpetiformis

Dermatitis Herpetiformis.

Dermatitis Herpetiformis

dd, dermatitis herpeteformis.bullous pemphigoid. Inv.janck smear. Biopsy to confirm dx rx accordingly

herpes zoster

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