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.
引用
收藏
页码:23 / 31
页数:9
相关论文
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