Antigliadin antibodies in dermatitis herpetiformis.

DERMATITIS herpetiformis (DH) is an intensely itchy dermatosis of a chronic nature. Although the lesions most often consist of tense vesicles grouped on the extensor surfaces of the body, they may also be erythematous, urticarial or papular and more diffuse. As a result of the intense itch the lesions are excoriated and frequently present as small crusted areas. Thus other parameters are necessary to assist in diagnosis. For many years therapeutic response to sulphones or sulfrapyridine was an important criterion in diagnosis, while more recently the diagnosis has been confirmed by the finding of deposits of immunoglobulin A (IgA) in clinically uninvolved skin. Since gluten sensitive enteropathy occurs in all patients with DH in varying degrees,' associated villous atrophy in jejunal biopsies has been used as an additional diagnostic aid. The presence of a serum antibody to gliadin, a component of gluten, has been associated with patients with gluten sensitive enteropathy,2,3 and we suggest that detection of this antibody may be an additional help in differentiating patients with DH from patients with other itchy skin conditions and may in certain cases eliminate the need for a jejunal biopsy sample.