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Case History #3

Case History #3. S.T ., a 39 year old man comes to your office complaining of diffuse, itchy and red lesions. He just returned from his beach house having been told that sunbathing would improve his condition. During this vacation, he consumed mainly seafood and white bread.

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Case History #3

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  1. Case History #3 S.T., a 39 year old man comes to your office complaining of diffuse, itchy and red lesions. He just returned from his beach house having been told that sunbathing would improve his condition. During this vacation, he consumed mainly seafood and white bread.

  2. So What is your Differential Diagnosis?

  3. DIFFERENTIAL DIAGNOSIS • Differential Diagnosis • Allergic contact dermatitis • atopic dermatitis • Dermatitis herpetiformis • scabies • Herpetic neurotic excoriations • papular uticaria • bullous pemphigoid • herpes gestationis

  4. Signs and Symptoms • Epidemiology- age of onset ranges from 20-60 but more commonly appears between 30-40. • Classic locations- elbow, knee, buttocks, scapular and sacral areas, scalp, face and hairline. • Erythematous papules or wheal-like plaques; tiny firm-topped vesicles sometimes hemorrhagic; occasional bullae; arranged in groups with a symmetric distribution. • Pruritus, intense and episodic; burning or stinging of the skin.

  5. Diagnosis • Ingestion of iodides (seafood) and gluten (white breads) are exacerbating factors. • Confirmation of Diagnosis of Dermatitis Herpetiformis • Biopsy of early lesions • IgA deposits detected via immunofluorescence

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