Answer :USMLE step 2 Mcq 359:A 60 year old man has a 10 day history of nonproductive cough and dyspnea on exertion




Correct Answer: C

Dermatitis herpetiformis is idiopathic (without known cause), but several immunologic abnormalities have been detected. The presence in lesions of IgA (immunoglobulin) and complement components supports an immunoregulatory disturbance. Iodide and other halides may cause a flare. Onset may be at any age, but it usually occurs in middle adult life. A slow onset during adulthood is typical, but children can be affected. Males are affected more than females. It appears to have its highest prevalence in Scandinavia  Small blisters, discrete papules (bumps), and itchy, smooth lesions resembling hives appear symmetrically on the head, elbows, knees, lower back, and buttocks. Quite often, blisters and papules occur on the face and neck. Itching and burning may be almost intolerable, and the need to scratch irresistible. Ingestion of gluten plays a role in the exacerbation of skin lesions.


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