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patients was found to be high (16%), and was comparable with the rate reported by Cardinali et al. 3 (5%).Supporting the observations of Woo et al., our group recently described a case of severe psoriasis in a patient with CD that did not respond to specific therapies for psoriasis. 4 EmA was absent, and IgA and IgG AGA serum levels were not raised. Diagnosis of CD was performed by jejunal biopsy, which showed atrophy of the intestinal villi. A gluten-free diet (GFD) was started, with rapid improvement of the duodenal mucosa and skin lesions. This case supports the association between CD and psoriasis, and the concept that psoriasis in CD patients can be improved by a GFD. This association was subsequently confirmed by Ojetti et al., 5 who showed a higher prevalence of CD in psoriatic patients than in controls.However, we are partially in disagreement with the authors on the correlation between CD-associated antibody positivity in psoriatic patients and greater disease activity. In our study we described a case of severe psoriasis in a CD patient with IgA and IgG AGA and EmA negativity. On this basis, we cannot affirm that CD-associated antibodies, in particular IgA and IgG AGA and TGA, have a predictive role for the presence of severe psoriasis in patients with CD.

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