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Question:

My seven year daughter, who has had diabetes since the age of one, was just diagnosed with celiac disease. In the process of diagnosis, the gastroenterologist suggested she have the rash on her knees biopsied for dermatitis herpetiformis by a dermatologist (because it was less invasive than the intestinal biopsy). The dermatologist looked at the rash and said that it was not dermatitis herpetiformis, but proceeded to do a biopsy of her forearm anyway. Is it possible to determine dermatitis herpetiformis from skin that does not have a lesion? Everything that I have read says that the biopsy must be done on the border of the lesion. Eventually, she was diagnosed with celiac disease via intestinal biopsy.

Answer:

One of my textbook references regarding the biopsy of tissue to help establish a diagnosis of dermatitis herpetiformis indicates that:

Skin biopsies for immunofluorescence studies are taken from adjacent normal or faintly erythematous skin... Multiple specimens may be needed to obtain positive findings because of the focal nature of deposits. Normal skin sites of more than 3 mm from a lesion or sites in areas not commonly involved may test negative.

DS

DTQ-20010504135833A
Original posting 11 May 2001
Posted to Other Illnesses

  
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Last Updated: Tuesday April 06, 2010 15:09:22
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