Clinical, histological and immunpathological findings in 32 patients with dermatitis herpetiformis Duhring

Rosé, Christian; Bröcker, Eva‐Bettina; Zillikens, Detlef

doi:10.1111/j.1610-0387.2009.07292.x

Cited by 33 publications

(40 citation statements)

References 22 publications

(23 reference statements)

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“…Although DH patients may present with longterm severe intestinal disease, they tend to have a generally less severe form of celiac disease and tend to be diagnosed at a later age than celiac patients (24). IgA TG2 Abs are present in most DH patients (10,25,26). TG3 is also produced in the gut.…”

Section: Discussionmentioning

confidence: 99%

Dermatitis Herpetiformis Sera or Goat Anti–Transglutaminase-3 Transferred to Human Skin-Grafted Mice Mimics Dermatitis Herpetiformis Immunopathology

Zone

Schmidt

Taylor

et al. 2011

The Journal of Immunology

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Dermatitis herpetiformis (DH) is characterized by deposition of IgA in the papillary dermis. However, indirect immunofluorescence is routinely negative, raising the question of the mechanism of formation of these immune deposits. Sárdy et al. (2002. J. Exp. Med. 195: 747–757) reported that transglutaminase-3 (TG3) colocalizes with the IgA. We sought to create such deposits using passive transfer of Ab to SCID mice bearing human skin grafts. IgG fraction of goat anti-TG3 or control IgG were administered i.p. to 20 mice. Separately, sera from seven DH patients and seven controls were injected intradermally. Biopsies were removed and processed for routine histology as well as direct immunofluorescence. All mice that received goat anti-TG3 produced papillary dermal immune deposits, and these deposits reacted with both rabbit anti-TG3 and DH patient sera. Three DH sera high in IgA anti-TG3 also produced deposits of granular IgA and TG3. We hypothesize that the IgA class anti-TG3 Abs are directly responsible for the immune deposits and that the TG3 is from human epidermis, as this is its only source in our model. These deposits seem to form over weeks in a process similar to an Ouchterlony immunodiffusion precipitate. This process of deposition explains the negative indirect immunofluorescence results with DH serum.

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Section: Discussionmentioning

confidence: 99%

Dermatitis Herpetiformis Sera or Goat Anti–Transglutaminase-3 Transferred to Human Skin-Grafted Mice Mimics Dermatitis Herpetiformis Immunopathology

Zone

Schmidt

Taylor

et al. 2011

The Journal of Immunology

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“…Regarding to the T-score at lumbar axis, it value was -0.855 ± 1.227 g/cm 2 in patients with DH, and -1.848 ± 1.398 g/cm 2 in those with CD (p < 0.001). At left femoral neck, T-scores were 0.182 ± 1.183 g/cm 2 in DH patients, and -1.165 ± 1.295 g/cm 2 in CD patients, respectively (p < 0.001).…”

Section: Resultsmentioning

confidence: 89%

“…The vast majority of DH patients do not have any abdominal complaint, even when more than 75-90 % of all cases present histological changes in their small bowel mucosa similar to those in CD patients: partial or total villous atrophy and lymphocytic infiltration of the bowel's mucous membrane (2,22).…”

Section: Discussionmentioning

confidence: 99%

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Does dermatitis herpetiformis result in bone loss as coeliac disease does?: a cross sectional study

Lőrinczy

Juhász

Csontos

et al. 2013

Rev. esp. enferm. dig.

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Introduction and objectives: coeliac disease (CD) and its cutaneous manifestation, dermatitis herpetiformis are both (DH) glutensensitive diseases. Metabolic bone disease is common among patients with CD, even in asymptomatic forms. Data are scarce about bone density in patients with dermatitis herpetiformis. The aim of our study was to compare bone mineral density (BMD) of celiac and dermatitis herpetiformis patients.Methods: 34 coeliac patients, 53 with dermatitis herpetiformis and 42 healthy controls were studied. The mean age was 38.0 ± 12.1, 32.18 ± 14.95, 35.33 ± 10.41 years in CD, dermatitis herpetiformis, and healthy controls, respectively. Bone mineral density of the lumbar spine, the left femoral neck and radius were measured by dual-energy X-ray absorptiometry. Low bone density, osteopenia and osteoporosis were defined as a body mass density (BMD) T-score between 0 and -1, between -1 and -2.5, and under -2.5, respectively.Results: at lumbar region, consisting of dominantly trabecular compartment, a decreased BMD was detected in 49 % (n = 26) patients with dermatitis herpetiformis, 62 % (n = 21) of CD patients, and 29 % (n = 12) of healthy controls, respectively. Lower BMD were measured at the lumbar region in dermatitis herpetiformis and CD compared to healthy subjects (0.993 ± 0.136 g/cm 2 and 0.880 ± 0.155 g/cm 2 vs. 1.056 ± 0.126 g/cm 2 ; p < 0.01). Density of bones consisting of dominantly cortical compartment (femoral neck) did not differ in dermatitis herpetiformis and healthy subjects.Conclusions: our results show that a low bone mass is also frequent among patients with dermatitis herpetiformis. Bone mineral content in these patients is significantly lower in those parts of the skeleton which contain more trabecular than cortical bone.

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“…U prezentowanych pacjentów zmiany skórne wystąpiły kilka lat po zdiagnozowaniu CD.Chłopcy nie przestrzegali zaleceń dietetycznych. Badacze sugerują, że przyczyną zmian skórnych u osób z celiakią może być zjawisko wewnątrzcząsteczkowego rozprzestrzeniania się epitopów w obrębie transglutaminaz, prowadzą-ce do powstania przeciwciał o dużym powinowactwie do eTG [8].…”

Section: Omówienieunclassified

Dühring Disease in Children with Type 1 Diabetes Mellitus

Salmonowicz¹,

Chrzanowska²

2013

Pediatr. Endocrinol.

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STRESZCZENIE/ABSTRACTOpryszczkowate zapalenie skóry (dermatitis herpetiformis, DH) zostało opisane przez Louisa Dühringa w roku 1884. Jest chorobą autoimmunologiczną, w której patogenezie istotną rolę odgrywa nietolerancja glutenu. Na szczycie brodawek blisko granicy skórno-naskórkowej dochodzi do odkładania się ziarnistych złogów IgA, które wykrywa się stosując metodę immunofluorescencji bezpośredniej. Zmiany skórne o różnym typie (grudki, rumienie, niewielkie pęcherze), swędzące, układające się symetrycznie, najczęściej zlokalizowane są na łokciach i kolanach, karku, owło-sionej skórze głowy oraz skórze twarzy, łopatkach, okolicy krzyżowej i pośladkach. Przedstawiamy trzech pacjentów, u których cukrzyca typu 1 współwystępowała z zapaleniem tarczycy, celiakią oraz opryszczkowatym zapaleniem skó-ry. Endokrynol. Ped. 12/2013;1(42):83-88.Dermatitis herpetiformis (DH) was described by Louis Dühring in 1884. In the pathogenesis of this autoimmune disease, gluten intolerance plays the most important role. At the top of the wart near the border of the dermalepidermal comes to the deposition of granular IgA deposits, which are detected using direct immunofluorescence method. The skin lesions of various types (papules, erythema, small blisters), itching, arranged symmetrically, usually located on the elbows, knees, neck, scalp, face, shoulders, sacral region and buttocks. The paper presents three patients with type 1 diabetes coincided with autoimmune thyroid disease, celiac disease and dermatitis herpetiformis. Pediatr.Endocrinol. 12/2013;1(42):83-88.

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Clinical, histological and immunpathological findings in 32 patients with dermatitis herpetiformis Duhring

Abstract: The detection of IgA autoantibodies against epidermal transglutaminase is the most sensitive serological test in the diagnosis of dermatitis herpetiformis. Our observations confirm that patients with dermatitis herpetiformis usually do not demonstrate apparent gastrointestinal symptoms.

Cited by 33 publications

References 22 publications

Dermatitis Herpetiformis Sera or Goat Anti–Transglutaminase-3 Transferred to Human Skin-Grafted Mice Mimics Dermatitis Herpetiformis Immunopathology

Dermatitis Herpetiformis Sera or Goat Anti–Transglutaminase-3 Transferred to Human Skin-Grafted Mice Mimics Dermatitis Herpetiformis Immunopathology

Does dermatitis herpetiformis result in bone loss as coeliac disease does?: a cross sectional study

Dühring Disease in Children with Type 1 Diabetes Mellitus

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