Eczema associated with dermatitis herpetiformis on the buttocks. Other commonly affected sites include the shoulders, knees and elbows. The vesicles are brittle and the patient soon breaks them by scratching. Intact vesicles are not seen in this picture either, only broken skin and scratch marks. For immunological staining, a biopsy is taken from healthy skin, not from the eczema. The diagnosis is confirmed by determination of serum transglutaminase antibodies and by small bowel biopsy.