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2010, Número 1

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Med Cutan Iber Lat Am 2010; 38 (1)


Dermatitis herpetiforme. Patogenia, diagnóstico y tratamiento

Iranzo FP

Idioma: Español
Referencias bibliográficas: 53
Paginas: 5-15
Archivo PDF: 609.80 Kb.


RESUMEN

La dermatitis herpetiforme es una enfermedad ampollosa autoinmune poco frecuente. Las lesiones clínicas son polimorfos y el estudio de anatomía patológica es inespecífico en un porcentaje elevado de casos, por ello su diagnóstico puede pasar desapercibido si no se realiza estudio de inmunofluorescencia directa y las pruebas complementarias pertinentes. Se considera la manifestación cutánea de una enteropatía por sensibilidad al gluten, asintomática en un elevado numero de casos. Frecuentemente se asocia a otras enfermedades autoinmunes y existe un riesgo de desarrollo de linfoma no Hodgkin de células T. Su diagnóstico se basa en la clínica, pruebas tisulares (histopatología e inmunofluorescencia directa) y serológicas (anticuerpos anti-endomisio, anti-transglutaminasa tisular y anti-transglutaminasa epidérmica). La base del tratamiento es la dieta sin gluten estricta que debe instaurarse precozmente con la finalidad de evitar complicaciones posteriores y mantenerse de por vida. La sulfona y otros fármacos son útiles para inducir la remisión de los síntomas cutáneos hasta el inicio del efecto de la dieta.


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