{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T03:24:11Z","timestamp":1787196251805,"version":"build-2736575974"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Pathol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Dermatitis herpetiformis (DH) is a rare, intensely pruritic cutaneous manifestation of celiac disease (CD), typically presenting with excoriated papulovesicular lesions on extensor surfaces. DH is associated with IgA autoantibodies against epidermal transglutaminase (eTG), which form granular immune deposits in the papillary dermis and induce subepidermal blistering. Histopathology usually shows papillary dermal microabscesses and granular IgA deposits on direct immunofluorescence. We describe two patients with atypical DH featuring fibrillar, rather than granular, IgA deposits and no evidence of CD. Importantly, in both patients, we are the first to show that eTG did not colocalize with the fibrillar IgA deposits in the skin. Awareness of this pattern is essential to avoid misdiagnosis and potentially unwarranted gluten\u2010free diets, as fibrillar DH is often unrelated to CD.<\/jats:p>","DOI":"10.1111\/cup.70200","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T02:31:11Z","timestamp":1787193071000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fibrillar\u2010Type Dermatitis Herpetiformis: An Underrecognized Variant That Is Rarely Associated With Celiac Disease and Lacking Epidermal Transglutaminase Deposition: A Report of Two Cases"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5997-7551","authenticated-orcid":false,"given":"Jeffrey","family":"Damman","sequence":"first","affiliation":[{"name":"Department of Pathology Erasmus Medical Center Rotterdam  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0424-9799","authenticated-orcid":false,"given":"Elodie","family":"Mendels","sequence":"additional","affiliation":[{"name":"Department of Dermatology Erasmus Medical Center Rotterdam  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6192-8723","authenticated-orcid":false,"given":"Sven","family":"van der Woude","sequence":"additional","affiliation":[{"name":"Department of Pathology University Medical Center Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Veenbergen","sequence":"additional","affiliation":[{"name":"Department of Immunology Erasmus Medical Center Rotterdam  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8053-216X","authenticated-orcid":false,"given":"Gilles F. H.","family":"Diercks","sequence":"additional","affiliation":[{"name":"Department of Pathology University Medical Center Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1672-7899","authenticated-orcid":false,"given":"Martijn B.","family":"van Doorn","sequence":"additional","affiliation":[{"name":"Department of Dermatology Erasmus Medical Center Rotterdam  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.3389\/fimmu.2019.01290","article-title":"Dermatitis Herpetiformis: Novel Perspectives","volume":"10","author":"Antiga E.","year":"2019","journal-title":"Frontiers in Immunology"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1111\/jdv.17183","article-title":"S2K Guidelines (Consensus Statement) for Diagnosis and Therapy of Dermatitis Herpetiformis Initiated by the European Academy of Dermatology and Venereology (EADV)","volume":"35","author":"G\u00f6r\u00f6g A.","year":"2021","journal-title":"Journal of the European Academy of Dermatology and Venereology"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/j.jaad.2011.02.025","article-title":"Novel Assay for Detecting Celiac Disease\u2013Associated Autoantibodies in Dermatitis Herpetiformis Using Deamidated Gliadin Analogous Fusion Peptides","volume":"66","author":"Kasperkiewicz M.","year":"2012","journal-title":"Journal of the American Academy of Dermatology"},{"issue":"4","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1001\/archderm.1993.01680250068008","article-title":"Confocal Laser Scanning Microscopic and Immunoelectron Microscopic Studies of the Anatomical Distribution of Fibrillar IgA Deposits in Dermatitis","volume":"129","author":"Kawana S.","year":"1993","journal-title":"Archives of Dermatology"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"562168","DOI":"10.1155\/2012\/562168","article-title":"Distinct Characteristics in Japanese Dermatitis Herpetiformis: A Review of All 91 Japanese Patients Over the last 35\u2009Years","volume":"2012","author":"Ohata C.","year":"2012","journal-title":"Clinical & Developmental Immunology"},{"issue":"4","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1111\/j.1365-2133.2010.10153.x","article-title":"Detection of Antibodies to Epidermal Transglutaminase but not Tissue Transglutaminase in Japanese Patients With Dermatitis Herpetiformis","volume":"164","author":"Asano Y.","year":"2011","journal-title":"British Journal of Dermatology"},{"issue":"5","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"642","DOI":"10.2340\/00015555-2604","article-title":"Increased Serum Levels of Th2\u2010Type Cytokines and Eotaxin in Fibrillar\u2010Type Dermatitis Herpetiformis","volume":"97","author":"Makino T.","year":"2017","journal-title":"Acta Dermato\u2010Venereologica"},{"issue":"2","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1684\/ejd.2019.3533","article-title":"Fibrillar Type Dermatitis Herpetiformis","volume":"29","author":"Makino T.","year":"2019","journal-title":"European Journal of Dermatology"},{"issue":"5","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1111\/1523-1747.ep12261260","article-title":"Immunofluorescence Studies in the Diagnosis of Dermatitis Herpetiformis and Its Differentiation From Bullous Pemphigoid","volume":"56","author":"Chorzelski T. P.","year":"1971","journal-title":"Journal of Investigative Dermatology"},{"issue":"1","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1159\/000051808","article-title":"Dermatitis Herpetiformis in Japan: An Update","volume":"204","author":"Shibahara M.","year":"2002","journal-title":"Dermatology"},{"issue":"4","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.jdcr.2017.04.003","article-title":"Dermatitis Herpetiformis With Fibrillar IgA Deposition and Unusual Histologic Findings","volume":"3","author":"Miraflor A. P.","year":"2017","journal-title":"JAAD Case Reports"},{"issue":"4","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1111\/j.1600-0560.2009.01472.x","article-title":"Fibrillar IgA Deposition in Dermatitis Herpetiformis\u2014An Underreported Pattern With Potential Clinical Significance","volume":"37","author":"Ko C. 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