A man in his 30s who suffered severely itchy skin lesions on his face and body for a five-year period due to misdiagnosis by a dermatologist has received £30,000 in compensation.
He was seen by a dermatologist four times in 14 months who misdiagnosed him with conditions such as herpes, impetigo and bacterial skin infections.
The man was eventually diagnosed with the autoimmune conditions dermatitis herpetiformis and related coeliac disease. However, owing to the five-year delay, he developed osteoporosis which caused spinal fractures and a loss of height by 6cm.
He was supported by specialist solicitor, Sarah Johnson of Medical Solicitors’ York office, to make a medical negligence claim against the defendant NHS hospital trust.
Case summary
From the age of 12, the claimant ‘C’ has suffered with a skin condition treated by various GPs with a combination of antibiotics and topical creams.
In December 2010, when C was 23, he was referred to dermatology at the defendant hospital for more advice and specialised treatment for his blistered skin.
C was first seen by a dermatologist in February 2011 who gave a differential diagnosis of recurrent herpes simplex or bullous impetigo. Swabs were taken and C was prescribed oral antibiotics and an antimicrobial wash.
C was seen again in June 2011 by the same dermatologist who noted the very itchy nature of the blisters. Another diagnosis was made of staph colonisation, a bacterial skin infection, and C was started on a staph eradication regimen along with more antibiotics.
In December 2011, C was seen again by the same dermatologist. By then, he had developed crusting and folliculitis. Treatment was changed to a different antibiotic and C was advised to continue with the antimicrobial wash.
By April 2012, C’s skin had visibly improved, except for a lesion on his beard line. He was discharged from the clinic by the dermatologist.
Four years later, in April 2016, C had a skin biopsy and immunofluorescence, from which he was diagnosed with dermatitis herpetiformis.
This is a chronic autoimmune blistering skin condition that affects around 1 in 10,000 people. It is linked to coeliac disease: the body’s immune system reacts to gluten, causing a skin rash to develop.
C was subsequently diagnosed with coeliac disease. After starting a gluten-free diet, his skin condition rapidly improved but he has been left with scarring to his face and body.
However, by 2017, he had moved to work abroad. Following a fall, he fractured two ribs. A bone density scan showed he had osteoporosis and was deficient in vitamin D and iron. Malabsorption of vitamins and minerals is a known complication of coeliac disease.
C was referred to an endocrinologist who noted a loss of height of 2cm caused by the weakening of C’s bones.
In 2020, he experienced a four-month period of back pain when exercising. Bone mapping showed fresh compression fractures in the thoracic vertebrae, resulting in C having Teriparatide injections for two years to treat the osteoporosis.
His bone density has improved after treatment, however he has lost a total of 6cms in height.
Litigation
C alleged that there was a failure by the dermatologist to consider a diagnosis of dermatitis herpetiformis at any of the four consultations in 2011 and 2012. Due to the itchy nature of the blisters, it was unlikely to be impetigo or herpes. C alleged that the dermatologist failed to take a correct medical history.
He also argued that, had the biopsy and immunofluorescence been carried out earlier than 2016, a diagnosis would have been made much sooner, resulting in more timely treatment.
The five-year delay led to a worsening of his bone density and him developing spinal fractures some 30 years before expected.
The case was contested and so proceedings were issued and served. Following a Defence and after some further negotiations, the defendant made an offer of £30,000, which the claimant accepted.
