Cœliac Syndrome in Dermatitis Herpetiformis

Shuster, Sam; Watson, Alexander; Marks, Janet

doi:10.1016/s0140-6736(68)90181-5

Cited by 176 publications

(69 citation statements)

References 14 publications

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“…Dermatitis herpetiformis (DH)1 is frequently associated with duodenal-jejunal villous atrophy similar to that found in gluten-sensitive enteropathy (GSE)' (1,2). The basis for this association is unknown.…”

Section: Introductionmentioning

confidence: 79%

“…Firstly, the mucosal changes observed in patients with DH are reversible with a gluten-free diet whereas the eruption usually does not respond to this treatment (1,11,12). Conversely, sulfone or sulfapyridine administration is an effective treatment for the rash but does not reverse the intestinal abnormalities in patients with DH or GSE (1,12). Secondly, the skin lesions of DH show subepidermal blisters with an acute inflammatory infiltrate of neutrophils and eosinophils in the dermal papillae adjacent to the blister.…”

Section: Discussionmentioning

confidence: 99%

“…Duration of disease Received for publication 11 Maly 1972 and in revised form 30 August 1972. 1 Abbreviations used in this paper: DH, dermatitis herpetiformis; GSE, gluten-sensitive enteropathy; Ir, immune response.…”

Section: Methodsmentioning

confidence: 99%

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HL-A8: a genetic link between dermatitis herpetiformis and gluten-sensitive enteropathy

Si¹,

Zm²,

Mv³

et al. 1972

J. Clin. Invest.

141

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A B S T R A C T Histocompatibility antigen HL-A8 was found in 58% of 26 patients with dermatitis herpetiformis (DH) compared to 24% of a normal group. This difference in antigen frequency is significant at the P < 0.003 level. In a previous study, the frequency of this same genetic xnarker was found to be significantly increased in patients with gluten-sensitive enteropathy (GSE) (88% in patients vs. 22% in controls). The finding of an increased incidence of the HL-A8 antigen in both DH and GSE supports the concept that these diseases are related and provides a genetic basis for the association between the two.

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Section: Introductionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

HL-A8: a genetic link between dermatitis herpetiformis and gluten-sensitive enteropathy

Si¹,

Zm²,

Mv³

et al. 1972

J. Clin. Invest.

141

View full text Add to dashboard Cite

show abstract

“…In 1965, Shuster and Marks [49] showed relationships between the skin disease and abnormalities of small bowel mucosa, and in 1968 [50] the same group established that the bowel responded to a gluten-free diet. The likelihood that all, or almost all, patients with dermatitis herpetiformis have abnormalities of the small bowel mucosa was suggested in 1971 [51] .…”

Section: Dermatitis Herpetiformismentioning

confidence: 99%

A History of Coeliac Disease

Losowsky¹

2008

Dig Dis

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Coeliac disease may have an ancient history dating back to the 1st and 2nd centuries AD. The first clear description was given by Samuel Gee in 1888. He suggested that dietary treatment might be of benefit. In the early 20th century various diets were tried, with some success, but without clear recognition of the toxic components. The doctoral thesis of Wim Dicke of 1950 established that exclusion of wheat, rye and oats from the diet led to dramatic improvement. The toxicity was shown to be a protein component, referred to as gluten. Dicke’s colleagues, Weijers and Van de Kamer, showed that measurement of stool fat reflected the clinical condition. Early studies were in children but stool fat measurements documented that the condition could be recognised in adults. Histological abnormalities of the lining of the small intestine were demonstrated beyond doubt by Paulley in 1954 and techniques of per-oral biopsy described by Royer in 1955 and Shiner in 1956 afforded reliable diagnosis. Concurrence in monozygotic twins suggested a genetic component, confirmed by studies of HLA antigens. Additional, non-genetic factors seem likely. Circulating antibodies suggest an immunological mechanism of damage and provide non-invasive screening tests. Lymphoma, adenocarcinoma and ulceration of the small intestine and a range of immunological disorders are associated. A relationship with dermatitis herpetiformis was suggested by Samman in 1955 and established by Shuster and Marks in 1965 and 1968. The Coeliac Society (now Coeliac UK) was founded in 1968 and similar societies now exist across the world. They provide an extremely valuable service. Present problems include definition of the tolerated levels of gluten, whether oats are toxic for some or all coeliacs and the likelihood that the condition is relatively common and frequently without classical symptoms. Hope for the future is that more convenient methods of treatment will follow better understanding.

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“…[13][14][15] An occurrence of the association between alterations in the jejune mucosa and the deposit of immunoglobulin A (IgA) in the papillary dermis was described in 1966. 16,17 This pathology was the dermatitis herpetiformis (DH), which is characterized by urticarial bullous lesions (often excoriated by pruritus) associated to gluten-sensitive enteropathy, being symptomatic or asymptomatic. 4,18 The present study describes the case of a patient with CD diagnosis, suspected due to typical lesions of DH, with favorable evolution with a gluten-free diet, showing regression of cutaneous lesions.…”

Section: Introductionmentioning

confidence: 99%

Dermatite herpetiforme como única manifestação de doença celíaca: relato de caso e revisão da literatura

Sgnaolin¹,

Baldisserotto²,

Stein³

et al. 2014

Sci Med

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Aims: To present a case of dermatitis herpetiformis, a papulovesicular rash due to deposits of immunoglobulin A in the papillary dermis. This is a common extraintestinal manifestation of celiac disease, although rare in childhood. Case description: A 10-year-old girl was diagnosed with celiac disease, suspected only due to the occurrence of typical lesions of dermatitis herpetiformis. Intestinal biopsy demonstrated total atrophy of duodenal villi in spite of the lack of clinical digestive manifestations. Under a gluten-free diet the patient presented favorable evolution, with regression of cutaneous lesions. Conclusions: Dermatitis herpetiformis is a common manifestation of celiac disease, but is not frequent in infants. Therefore, is very important to investigate any child that presents a chronic papulovesicular cutaneous eruption non-responsive to usual treatments in order to perform a precocious diagnosis of celiac disease, avoiding its serious repercussions. KEY WORDS: DERMATITIS HERPETIFORMIS; CELIAC DISEASE; GLUTENS; CHILD. RESUMOObjetivos: Apresentar um caso de dermatite herpetiforme, uma erupção cutânea papulovesicular pruriginosa devida ao depósito de imunoglobulina A na derme papilar. Esta é uma manifestação extraintestinal comum da doença celíaca, embora rara na infância. Descrição do caso: Uma paciente com 10 anos de idade foi diagnosticada com doença celíaca, cuja suspeita surgiu unicamente em decorrência de lesões típicas de dermatite herpetiforme. A biópsia intestinal demonstrou atrofia total das vilosidades duodenais, apesar da ausência de manifestações clínicas digestivas. Com dieta livre de glúten a paciente apresentou evolução favorável, com regressão das lesões cutâneas. Conclusões: A dermatite herpetiforme é uma manifestação comum da doença celíaca que, no entanto, é infrequente na infância. Por isso, é fundamental alto grau de suspeição em qualquer criança que apresentar uma erupção cutânea papulovesicular crônica não responsiva a medidas simples, a fim de realizar o diagnóstico precoce da doença celíaca, evitando suas graves repercussões.

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Cœliac Syndrome in Dermatitis Herpetiformis

Cited by 176 publications

References 14 publications

HL-A8: a genetic link between dermatitis herpetiformis and gluten-sensitive enteropathy

HL-A8: a genetic link between dermatitis herpetiformis and gluten-sensitive enteropathy

A History of Coeliac Disease

Dermatite herpetiforme como única manifestação de doença celíaca: relato de caso e revisão da literatura

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