Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, intensely pruritic, papulovesicular eruption distributed symmetrically on extensor surfaces (elbows, knees, buttocks, and sacrum). Reports burning/stinging sensation preceding lesion onset. Denies personal history of blistering disorders but notes associated symptoms of abdominal bloating, steatorrhea, or weight loss suggestive of underlying gluten-sensitive enteropathy.
Clinical Examination Findings
Dermatological examination reveals grouped, excoriated vesicles and papules on an erythematous base, primarily localized to extensor surfaces. Absence of mucosal involvement noted. Patient exhibits no signs of systemic distress; abdominal examination is benign, though screening for signs of malabsorption is indicated.
Treatment Protocol
Initiate Dapsone therapy (100-150 mg/day) following G6PD deficiency screening. Strict adherence to a lifelong gluten-free diet (GFD) is mandatory to manage underlying celiac disease and reduce medication requirements. Monitor CBC, LFTs, and renal function periodically.