The absence of BRAF, FGFR3, and PIK3CA mutations differentiates lentigo simplex from melanocytic nevus and solar lentigo.

tion or dapsone/sulfapyridine dose); however, future studies should attempt to correlate levels of IgA anti-eTG with parameters of disease activity, including degree and duration of gluten restriction, and dapsone/sulfapyridine dose. The patient presented in Table 2 shows that the levels of each Ab assay decreases over time with adherence to a gluten-free diet. Although definitive conclusions cannot be made from one patient, these results suggest that the levels of IgA against eTG correlate with dietary gluten intake. Prospective studies should be designed to evaluate the levels of IgA anti-eTG in DH patients over time after initiation of a gluten-free diet. IgA anti-eTG was present in only 11.1% of pediatric CD, which is significantly lower than that reported in adult CD (B50%) (Hull et al., 2008). These results are similar to our previously published data showing a low prevalence of IgA anti-eTG in pediatric CD patients. This occurred in the setting of significantly elevated concentrations of IgA anti-tTG (90.7%). The majority of the six pediatric CD patients with IgA anti-eTGþ results showed low titers (13, 13, 14, 15, 20, and 96 Units) and all were duodenal biopsy positive (1 of 18 Marsh 3a (5.6%), 1 of 15 Marsh 3b (6.7%), and 4 of 16 Marsh 3c (25.0%)). All six pediatric CD patients were also positive for IgA anti-tTG (6 of 6), for IgA anti-deamidated gliadin peptides (6 of 6), and for IgG antideamidated gliadin peptides (5 of 6). We will follow-up pediatric CD patients with IgA anti-eTGþ results to find out whether they develop symptoms of DH. In conclusion, IgA anti-eTG was more sensitive in detecting DH than any other marker associated with gluten-sensitive enteropathy and its prevalence is significantly lower in pediatric CD than that which has been reported in adult CD. In a patient suspected of having DH, the present data support testing for IgA anti-eTG, which may help in screening and monitoring the response to a gluten-free diet. We then recommend a biopsy of uninvolved, perilesional skin in an area of grouped vesicles or erosions for direct immunofluorescence, which is the gold standard for diagnosis.