A 26-year-old female presents with a rash on the back, elbows, buttocks and knees. The rash began acutely, associated with severe pruritis and burning sensation. Biopsy was done that shows immunofluorescence granular deposition of IgA in the papillary dermis, along the epidermal basement membrane zone and neutrophilic dermatitis within dermal papillae. So, what will be the course of management?

Dermatitis herpetiformis is an immunologic skin disease characterized by itchy papulovesicular lesions of the extremities, knees, elbows and buttocks. On immunofluorescence, there is granular deposits of IgA that is found in the papillary dermis and along with the epidermal basement membrane. Majority of these patients have associated gluten-sensitive enteropathy, that may be clinically unrecognized. Patients with DH can be managed by two complementary methods: - Medications: Dapsone (50-200 mg / daily), and it shows remarkable improvement within 1-2 days - Gluten free diet