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Certain factors, including lesions limited to the genitals, an initial biopsy revealing nonspecific findings on microscopy studies, and the absence of characteristic direct immunofluorescence findings lessened initial clinical suspicions of DH over that of scabies infestation. Classic microscopic findings of DH were identified on repeat biopsy. Serologic studies revealed immunoglobulin <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content> (IgA) endomysial and <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>g<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content> tissue transglutaminase positivity. Response to dapsone proved dramatic. Histopathologic findings, serology, and response to treatment rather than classical clinical findings and direct immunofluorescence supported the diagnosis of DH in this case.<\/jats:p>","DOI":"10.1111\/pde.12086","type":"journal-article","created":{"date-parts":[[2013,2,14]],"date-time":"2013-02-14T07:52:56Z","timestamp":1360828376000},"page":"511-514","source":"Crossref","is-referenced-by-count":1,"title":["An Unusual Case of Dermatitis Herpetiformis"],"prefix":"10.1111","volume":"31","author":[{"given":"Kara","family":"Clark","sequence":"first","affiliation":[{"name":"School of Medicine West Virginia University Morgantown West Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roxann","family":"Powers","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Dermatology West Virginia University Morgantown West Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodney","family":"Kovach","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Dermatology West Virginia University Morgantown West Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,2,14]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2010.09.777"},{"key":"e_1_2_5_3_1","first-page":"473","article-title":"Childhood dermatitis herpetiformis: a case report and review of the literature","volume":"80","author":"Templet JT","year":"2007","journal-title":"Cutis"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2005.06345.x"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2011.10385.x"},{"key":"e_1_2_5_6_1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1001\/jama.1975.03260010055023","article-title":"Scabies masquerading as dermatitis herpetiformis","volume":"233","author":"Ackerman AB","year":"1975","journal-title":"JAMA"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1996.03890320060010"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2007.03214.x"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1470.2002.00096.x"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2000.100543"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00412591"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2010.05.027"},{"key":"e_1_2_5_13_1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.5070\/D330M4B5KR","article-title":"Dapsone","volume":"8","author":"Wolf R","year":"2002","journal-title":"Dermatol Online J"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0738-081X(91)90021-C"}],"container-title":["Pediatric Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpde.12086","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.12086","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T13:57:05Z","timestamp":1695477425000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pde.12086"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,2,14]]},"references-count":13,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2014,7]]}},"alternative-id":["10.1111\/pde.12086"],"URL":"https:\/\/doi.org\/10.1111\/pde.12086","archive":["Portico"],"relation":{},"ISSN":["0736-8046","1525-1470"],"issn-type":[{"value":"0736-8046","type":"print"},{"value":"1525-1470","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,2,14]]}}}