Dermatitis herpetiformis (DH) is an IgA mediated blistering skin disease 
characterized by the presence of granular deposits of IgA in papillary dermis. 
The major significant advances in our understanding of DH have been the 
demonstration that DH patients also have coeliac diseases (CD) and that the rash 
is also gluten dependent. As a result, it is now possible to cure patients by 
gluten withdrawal from the diet. The other major significant finding has been 
the presence of IgA in the uninvolved, now used as the diagnostic criterion for 
the disease. Despite the fact that it has been known for over fifty years that 
gluten causes the enteropathy of CD, and for over thirty years the rash of DH, 
it is still not known how gluten produces these effects. Future immunological 
studies may look at ways of inducing tolerance to gluten peptides once the toxic 
ones have been identified. Vaccination against gluten peptides may also be 
possible in those affected with gluten sensitive disorders.