**16. Skin manifestation in CD**

Dermatitis herpetiformis in CD is the commonest and pathognomonic skin lesion. It presents usually on external surface in grouped in the form intensely pruritic papules and vesicles. The diagnosis is confirmed on histology by the demonstration of granular IgA deposits along the non-affected subepidermal basement membrane [86]. Similar to CD they have increased antibodies against tissue transglutaminase IgG. Dermatitis herpetiformis and CD, are associated with HLA-DQ alpha beta heterodimers, and may have association with other autoimmune illness as well. It responds well on gluten free diet though requires longer duration.

Patients with CD, also have increased incidence of atopic dermatitis as compared to general population [87].
