Dogma and dermatitis herpetiformis*

Marks, Janet

doi:10.1111/j.1365-2230.1977.tb02559.x

Cited by 40 publications

(23 citation statements)

References 48 publications

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“…Fry & Seah (1974a) have suggested that the presence of IgA in the skin must be an absolute criterion for the diagnosis of DH. While we agree that this is a highly characteristic feature of the disease, we have encountered 3 of 83 patients in whom repeated investigation failed to show cutaneous IgA, yet, who on all other grounds, were considered to have typical DH (Marks, 1977). Thus the presence of cutaneous IgA in typical patterns and distribution, correlates very closely, but not absolutely, with the diagnosis of DH and very occasionally both 'false' positive and negative findings occur.…”

Section: Discussionmentioning

confidence: 50%

“…A close association between dermatitis herpetiformis (DH) and coeliac disease (CD) has been established. Small intestinal mucosal biopsies in patients with DH have been reported to show changes indistinguishable from those of CD in between 66 and 95% (Tongeren, Staak & Schillings, 1967;Fry et al, 1972), the percentage depending to some extent upon the definition of CD (Marks, 1977). The abnormalities are reversible following treatment with a gluten free diet (GFD) (Shuster, Watson & Marks, 1968;Fry et al, 1968).…”

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confidence: 99%

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Absence of cutaneous IgA in coeliac disease without dermatitis herpetiformis

1978

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Skin biopsies from 17 patients with coeliac disease, but without dermatitis herpetiformis, were examined by direct immunofluorescence. In none of them was IgA detectable. In contrast, IgA was present in dermal papillae and/or in relation to the dermo-epidermal junction in 80 out of 83 patients with dermatitis herpetiformis. These findings confirm that cutaneous deposition of IgA at these sites is a very characteristic feature of dermatitis herpetiformis and is unrelated to coeliac disease itself.

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Section: Discussionmentioning

confidence: 50%

mentioning

confidence: 99%

Absence of cutaneous IgA in coeliac disease without dermatitis herpetiformis

1978

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“…Gluten-sensitive enteropathy occurs both in adults and in children with a reported incidence of 57-85% [2][3][4][5]. Raised intraepithelial lymphocyte counts [6].…”

Section: Discussionmentioning

confidence: 99%

Should all patients with dermatitis herpetiformis follow a gluten‐free diet?

Buckley

McDermott

O’Donoghue

et al. 1997

Acad Dermatol Venereol

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Aim To assess the effect of a gluten-free diet in Irish patients with dermatitis herpetiformis. and whether treatment with a gluten-free diet is as important for patients with a normal small bowel biopsy as for those with viUous atrophy.Background Though a gluten-free diet is recommended in the management of dermatitis herpetiformis, many patients find it intolerably resttictive. To date we have recommended it only to patients with abnormal small bowel histology.Method.s Forty patients with dermatitis herpetiformis who atlended our clinic between 1979 and 1994 were studied retrospectively. Vilious atrophy was present in 20 (64%) of 31 initial small bowel biopsies in patients not on a gluten-free diet. ResultsThe median time to a 50% reduction in dapsone requirements was 6 months in patients who followed a gluten-free diet (// = 14). 10.5 months in those who had a gluten-reduced diet (n = 4) and 10.5 months in those who took a normal diet (/? -22). Four of 14 patients (29%) on a gluten-free diet were able to discontinue medication in 1-5 years compared with 2 of 22 (9%) on a normal diet. The mean time to a 50% reduction in dapsone requirements was similar in patients with and without vilious atrophy, 9.3 versus 9.0 months in patients on a gluten-free diet and 12.0 versus 15.3 months in patients on a normal diet.Conclusion We conclude that a gluten-free diet should be strongly encouraged in all dermatitis herpetiformis patients, since those with normal small bowel biopsy findings benefit equally from the diet as do those with vilious atrophy. © 1997 Elsevier Science B.V. I

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“…Although DH and LABD can resemble each other closely with the histopathological features of blisters in LABD and DH almost indistinguishable, their immunological features can be distinctive in both entities. In intact skin, especially adjacent to the lesions, granular IgA deposits are present, while the homogenous linear-band appearance of IgA in BMZ is almost pathognomonic of the diagnosis of DH and LABD, respectively [16, 17]. …”

Section: Discussionmentioning

confidence: 99%

Bullous Dermatosis in an End-Stage Renal Disease Patient: A Case Report and Literature Review

Bhat

Minshar

Imran

et al. 2016

Case Reports in Nephrology

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Patients with advanced chronic kidney disease including ESRD patients may present with a wide spectrum of cutaneous abnormalities, ranging from xerosis to hyperpigmentation to severe deforming necrotizing lesions. Skin problems are not uncommon in this population of patients, with a clinical presentation that can be quite bizarre, mandating a long list of differential diagnostic possibilities, and subsequent rise of a puzzling diagnostic challenge. We describe an ESRD patient who presented with blistering, nonhealing ulcerative lesions with a diagnostic skin biopsy revealing a mixed pattern of linear IgA bullous dermatosis and dermatitis herpetiformis. A clinical remission could be achieved with pulse intravenous steroids followed by oral maintenance in combination with dapsone, with no evidence of recurrence.

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Dogma and dermatitis herpetiformis*

Cited by 40 publications

References 48 publications

Absence of cutaneous IgA in coeliac disease without dermatitis herpetiformis

Absence of cutaneous IgA in coeliac disease without dermatitis herpetiformis

Should all patients with dermatitis herpetiformis follow a gluten‐free diet?

Bullous Dermatosis in an End-Stage Renal Disease Patient: A Case Report and Literature Review

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