Dermatitis herpetiformis (duhring-brocq disease)   359

General: Malignant; atypical; does not respond well to sulfone or sulfapyridine therapy; uncommon; autoimmune blistering dermatosis; pruritic eruption involving the scalp, buttocks, lower back, and extensor surface of arms; autoantibody is generally of immunoglobulin A class causing deposition at the dermal-epidermal junction.

Ocular: Bullae of conjunctiva, skin, and mucous membranes; blisters are intraepithelial (acantholysis) and usually do not leave scars; epithelium desquamates in patches; corneal and conjunctival vascularization; symblepharon; cataract.

Clinical: Vesicles; erythema; pruritus; burning; eruption classically involves extensor surface of the knees, elbows, buttocks, sacrum, scapula, and scalp.

Duane TD. Clinical Ophthalmology, vol. IV. Philadelphia: JB Lippincott, 1987.

Foster SC. Immunologic disorders of conjunctiva, cornea and sclera. In: Albert DM, Jakobiec FA, eds. Principles and Practice of Ophthalmology, vol. V. Philadelphia: WB Saunders, 1994:200.

Fraser NG, et al. Dermatitis herpetiformis and Sjogren's syndrome. Br J Dermatol 1979; 100:213-215.

Pau H. Differential diagnosis of eye diseases. New York: Thieme, 1987.