When should I consider referring a patient with dermatitis herpetiformis to a dermatologist for further management?

Consider referring a patient with dermatitis herpetiformis to a dermatologist for further management when:

• There is diagnostic uncertainty or confirmation of diagnosis is needed, as specialist assessment can clarify the condition.
• The patient has severe, extensive, or refractory symptoms that do not respond adequately to initial treatment in primary care.
• Systemic treatment such as dapsone or other immunosuppressants may be required, which necessitates specialist oversight.
• There are complications or atypical presentations that require specialist input.

Dermatitis herpetiformis is a chronic, autoimmune blistering skin condition linked to gluten sensitivity, and management often involves both dermatological and dietary interventions. Referral ensures accurate diagnosis, appropriate systemic therapy, and monitoring for associated conditions such as coeliac disease.

In summary, refer patients with dermatitis herpetiformis to dermatology when diagnosis is uncertain, when symptoms are severe or unresponsive to primary care treatment, or when systemic therapy is indicated.