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Dermatitis herpetiformis: a cutaneous manifestation of coeliac disease
被引:72
作者:
Collin, Pekka
[1
]
Salmi, Teea T.
[2
,3
]
Hervonen, Kaisa
[2
,3
]
Kaukinen, Katri
[3
,4
]
Reunala, Timo
[2
,3
]
机构:
[1] Tampere Univ Hosp, Dept Gastroenterol & Alimentary Tract Surg, Tampere, Finland
[2] Tampere Univ Hosp, Dept Dermatol, Tampere, Finland
[3] Univ Tampere, Sch Med, Tampere, Finland
[4] Tampere Univ Hosp, Dept Internal Med, Tampere, Finland
关键词:
Bullous dermatoses;
coeliac disease;
dermatitis herpetiformis;
gluten intolerance;
tissue transglutaminase;
GLUTEN-FREE DIET;
ANTIEPIDERMAL TRANSGLUTAMINASE ANTIBODIES;
BODY-MASS INDEX;
TISSUE TRANSGLUTAMINASE;
SKIN-LESIONS;
IGA DEPOSITS;
PREVALENCE;
DIAGNOSIS;
RISK;
POPULATION;
D O I:
10.1080/07853890.2016.1222450
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
Dermatitis herpetiformis (DH) is an itchy blistering skin disease with predilection sites on elbows, knees, and buttocks. Diagnosis is confirmed by showing granular immunoglobulin A deposits in perilesional skin. DH is one manifestation of coeliac disease; the skin symptoms heal with gluten free diet (GFD) and relapse on gluten challenge. Of the first-degree relatives, 5% may be affected by either condition. Tissue transglutaminase (TG2) is the autoantigen in coeliac disease and epidermal transglutaminase (TG3) in DH. Both diseases conditions exhibit TG2-specific autoantibodies in serum and small bowel mucosa; patients with DH have IgA-TG3 in the skin. There are some divergencies between these two phenotypes. One-fourth of DH patients do not have small bowel mucosal villous atrophy, but virtually all have coeliac-type inflammatory changes. The skin symptoms respond slowly to GFD. The incidence of coeliac disease is increasing, whereas the opposite is true for DH. A female predominance is evident in coeliac disease, while DH may be more common in males. Coeliac disease carries the risk of small intestinal T-cell lymphoma; in DH B-cell lymphomas at any site may prevail. Adult coeliac disease carries a slightly increased elevated mortality risk, whereas in DH, the relative mortality rate is significantly decreased.
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页码:23 / 31
页数:9
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