Approach to the Patient with Suspected Dermatitis Herpetiformis - Flowchart
Approach to the Patient with Suspected Dermatitis Herpetiformis - Flowchart Dermatitis Herpetiformis Dermatitis Herpetiformis
«Flowchart»

Patient with clinical findings of DH

Patient with clinical findings of DH

Patient with clinical findings of DH

Patient with clinical findings of DH

Serologic analysis


Total lgA level
Anti-tTG lgA, lgG
Anti-eTG (if available) lgA, lgG
Antiendomysial lgA, lgG

Serologic analysis


Total lgA level
Anti-tTG lgA, lgG
Anti-eTG (if available) lgA, lgG
Antiendomysial lgA, lgG

Serologic analysis

Serologic analysis


Total lgA level
Anti-tTG lgA, lgG
Anti-eTG (if available) lgA, lgG
Antiendomysial lgA, lgG


Total lgA level
Anti-tTG lgA, lgG
Anti-eTG (if available) lgA, lgG
Antiendomysial lgA, lgG


Treat per biopsy results
Monitor clinically


Treat per biopsy results
Monitor clinically


Treat per biopsy results
Monitor clinically


Treat per biopsy results
Monitor clinically

Serologic analysis


Total lgA level
Anti-tTG lgA, lgG
Anti-eTG (if available) lgA, lgG
Antiendomysial lgA, lgG

Serologic analysis


Total lgA level
Anti-tTG lgA, lgG
Anti-eTG (if available) lgA, lgG
Antiendomysial lgA, lgG

Serologic analysis

Serologic analysis


Total lgA level
Anti-tTG lgA, lgG
Anti-eTG (if available) lgA, lgG
Antiendomysial lgA, lgG


Total lgA level
Anti-tTG lgA, lgG
Anti-eTG (if available) lgA, lgG
Antiendomysial lgA, lgG

Biopsies


Lesional punch biopsy for H&E
Perilesional punch biopsy for DIF

Biopsies


Lesional punch biopsy for H&E
Perilesional punch biopsy for DIF

Biopsies

Biopsies


Lesional punch biopsy for H&E
Perilesional punch biopsy for DIF


Lesional punch biopsy for H&E
Perilesional punch biopsy for DIF

Findings consistent with another dermatosis, not DH

Findings consistent with another dermatosis, not DH

Findings consistent with another dermatosis, not DH Findings consistent with another dermatosis, not DH

Findings consistent with DH

Findings consistent with DH

Findings consistent with DH Findings consistent with DH

Equivocal

Equivocal

Equivocal Equivocal

End

End

End

Screening for associated disease


Thyroid function testing
Antithyroid peroxidase testing
Blood glucose screen
Other autoimmune serologic tests based on physical exam findings
If long-standing, blood smear

Screening for associated disease


Thyroid function testing
Antithyroid peroxidase testing
Blood glucose screen
Other autoimmune serologic tests based on physical exam findings
If long-standing, blood smear

Screening for associated disease

Screening for associated disease


Thyroid function testing
Antithyroid peroxidase testing
Blood glucose screen
Other autoimmune serologic tests based on physical exam findings
If long-standing, blood smear


Thyroid function testing
Antithyroid peroxidase testing
Blood glucose screen
Other autoimmune serologic tests based on physical exam findings
If long-standing, blood smear

Consider genetic testing


HLA-DQ2, HLA-DQ8

Consider genetic testing


HLA-DQ2, HLA-DQ8

Consider genetic testing

Consider genetic testing


HLA-DQ2, HLA-DQ8


HLA-DQ2, HLA-DQ8