Association Between Lichen Sclerosus and Celiac Disease: A Report of Three Pediatric Cases

Jacobs, Lauren; Gilliam, Amy E.; Khavari, M.P.H. Nasim; Bass, Dorsey

doi:10.1111/pde.12402

Cited by 14 publications

(15 citation statements)

References 15 publications

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“…Indeed, a frequent association with autoimmune diseases, thyroid disease, alopecia areata, vitiligo, and pernicious anemia has been reported [ 5 , 8 ]. Previous studies demonstrated an association with the risk of gastrointestinal diseases, such as ulcerative colitis, Crohn’s disease, chronic constipation, irritable bowel syndrome [ 19 ] and celiac disease [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Anti-Inflammatory and Tissue Regenerative Effects of Topical Treatment with Ozonated Olive Oil/Vitamin E Acetate in Balanitis Xerotica Obliterans

et al. 2018

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Balanitis xerotica obliterans (BXO) is a chronic inflammatory skin disorder, considered the male genital variant of lichen sclerosus. Anti-inflammatory drugs are commonly used in BXO. We evaluated the effects of an innovative formulation of ozonated olive oil with vitamin E acetate (OZOILE®) on the inflammatory status and tissue remodeling in male children with BXO. The mRNA transcripts of proteins involved either in inflammation or in dynamics of tissue regeneration were analyzed by quantitative real-time PCR, in foreskins affected by BXO removed from patients untreated or treated with OZOILE® cream for 7 days before circumcision. We found a significant reduction in mRNA levels of IL-1β, TNF-α, INF–γ, transglutaminase 2 and NOS2 in foreskins treated with OZOILE® in comparison to untreated ones (p < 0.001). No significant differences were observed in NF-κB activation in the specimens obtained from treated and untreated patients. Hence, OZOILE® treatment up-regulated hypoxia-inducible factor (HIF)-1alpha, vascular endothelial growth factor (VEGF) and E-cadherin gene expression (p < 0.001). The treatment with OZOILE® showed effective results in children affected by BXO by reducing the inflammatory process and stimulating mechanisms for tissue regeneration of the foreskin. A randomized clinical trial on a large number of children affected by BXO might be useful to verify the efficacy of topical treatment with OZOILE®.

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Section: Discussionmentioning

confidence: 99%

Anti-Inflammatory and Tissue Regenerative Effects of Topical Treatment with Ozonated Olive Oil/Vitamin E Acetate in Balanitis Xerotica Obliterans

et al. 2018

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“…Additional case reports and studies of small sample size have observed celiac disease with concomitant skin diseases, including lichen sclerosus, vitiligo, and alopecia areata, 14,15,59 although these diseases do not always improve with a glutenfree diet and potential genetic and environmental links have not been elucidated. 14,15 Earlier studies demonstrated an increased risk of melanoma in adults with celiac 60,61 ; however, a population-based study of 29,028 patients with celiac disease found no significant association in all age groups and with sex stratification.…”

Section: Atopic Dermatitismentioning

confidence: 99%

Could it be gluten? Additional skin conditions associated with celiac disease

2021

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Celiac disease is a multifactorial, inflammatory disorder initiated and sustained by the ingestion of gluten. Occurring across a broad population, the intestinal and extraintestinal manifestations of celiac disease are variable in severity and may be nonspecific in presentation. Given that environmental, genetic, and immune factors involved in the pathogenesis of celiac disease that the digestive tract and skin share many characteristics, and with a prevalence of 0.5-1% in most populations, it is reasonable to consider varying presentations of skin conditions that are linked with celiac disease. The association between celiac disease and skin conditions has been discussed earlier, but new studies have emerged suggesting cutaneous involvement in addition to dermatitis herpetiformis.We review the current literature identifying the relationship and potential mechanisms between celiac disease and various skin conditions.

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“…If the diagnosis of BXO was confirmed, the boy was referred to a dermatologist, and screening for thyroid and celiac disease was advised, since cutaneous involvement and association with these autoimmune diseases have been described in the literature, especially in adulthood [8,9]. All the reported complications were classified according to the modified Clavien-Dindo scale [10].…”

Section: Populationmentioning

confidence: 99%

Could a careful clinical examination distinguish physiologic phimosis from balanitis xerotica obliterans in children?

et al. 2020

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The diagnosis of balanitis xerotica obliterans (BXO) in children may be challenging, since clinical examination only could lead to an underestimation of its incidence. The aim of this retrospective and single-centre study is to assess the diagnostic performance of clinical examination, together with clinical history, in identifying BXO. Ninety-seven children underwent circumcision for phimosis from 2015 to 2019. Histology was routinely performed. Cohen’s kappa coefficient, sensitivity, specificity, predictive values, likelihood ratios and accuracy of macroscopic appearance of the foreskin, steroid administration and past medical history were estimated. Forty-eight patients (50%) were affected by BXO; 31 of them (69%) presented with suggestive clinical signs. A strictured or whitish urethral meatus was detected during surgery in nine cases (19%); this was associated to allergic or immune diseases (p = 0.046). Foreskin appearance alone mildly correlated with histology (k = 0.494; p < 0.001) and it showed a diagnostic accuracy of 75%. The specificity and positive predictive value of abnormal macroscopic findings at examination, together with a positive clinical history for other allergic or immune diseases, and/or for balanitis, were 100% and the positive likelihood ratio was greater than 10. Conversely, sensitivity decreased to 4.5% (95% CI 0–11%).Conclusion: Foreskin appearance together with clinical history could predict BXO with certainty. However, since the absence of a positive medical history could not exclude the diagnosis, foreskin histology is still highly recommended. What is Known:• Occurrence of balanitis xerotica obliterans may be underestimated in children and it could lead to long-term complications.• The diagnostic accuracy of clinical examination is controversial. What is New:• Clinical signs together with patients’ medical history present high specificity and positive predictive values but low sensitivity.• When suggestive clinical aspects are present, patient should be referred to surgery avoiding prolonged conservative treatment; and preputial histology is highly recommended.

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Association Between Lichen Sclerosus and Celiac Disease: A Report of Three Pediatric Cases

Cited by 14 publications

References 15 publications

Anti-Inflammatory and Tissue Regenerative Effects of Topical Treatment with Ozonated Olive Oil/Vitamin E Acetate in Balanitis Xerotica Obliterans

Anti-Inflammatory and Tissue Regenerative Effects of Topical Treatment with Ozonated Olive Oil/Vitamin E Acetate in Balanitis Xerotica Obliterans

Could it be gluten? Additional skin conditions associated with celiac disease

Could a careful clinical examination distinguish physiologic phimosis from balanitis xerotica obliterans in children?

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