Dermatitis Herpetiformis Refractory to Gluten-free Dietary Treatment

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dc.contributor.author Hervonen, Kaisa
dc.contributor.author Salmi, Teea T.
dc.contributor.author Ilus, Tuire
dc.contributor.author Paasikivi, Kaija
dc.contributor.author Vornanen, Martine
dc.contributor.author Laurila, Kaija
dc.contributor.author Lindfors, Katri
dc.contributor.author Viiri, Keijo
dc.contributor.author Saavalainen, Paivi
dc.contributor.author Collin, Pekka
dc.contributor.author Kaukinen, Katri
dc.contributor.author Reunala, Timo
dc.date.accessioned 2016-02-25T07:54:02Z
dc.date.available 2016-02-25T07:54:02Z
dc.date.issued 2016
dc.identifier.citation Hervonen , K , Salmi , T T , Ilus , T , Paasikivi , K , Vornanen , M , Laurila , K , Lindfors , K , Viiri , K , Saavalainen , P , Collin , P , Kaukinen , K & Reunala , T 2016 , ' Dermatitis Herpetiformis Refractory to Gluten-free Dietary Treatment ' , Acta Dermato-Venereologica , vol. 96 , no. 1 , pp. 82-86 . https://doi.org/10.2340/00015555-2184
dc.identifier.other PURE: 60341465
dc.identifier.other PURE UUID: be6ff50a-e4d6-4741-b864-db30c293ab9d
dc.identifier.other WOS: 000368870700015
dc.identifier.other Scopus: 85018195773
dc.identifier.uri http://hdl.handle.net/10138/160248
dc.description.abstract Dermatitis herpetiformis (DH) is a blistering skin disease, which is regarded as an extra-intestinal manifestation of coeliac disease. Refractory cases of coeliac disease, that do not respond to a gluten-free diet and which carry an increased risk of lymphoma, are well-known in coeliac disease. To determine whether refractory cases of DH with active rash and persistent small bowel atrophy occur we analysed our series of 403 patients with DH. Seven (1.7%) patients, who had been on a gluten-free diet for a mean of 16 years, but who still required dapsone to treat the symptoms of DH, were identified. Of these, one patient died from mucinous adenocarcinoma before re-examination. At re-examination skin immunoglobulin A (IgA) deposits were found in 5/6 refractory and 3/16 control DH patients with good dietary response. Small bowel mucosa was studied at re-examination from 5 refractory and 8 control DH patients and was normal in all 5 refractory and 7/8 control DH patients. One refractory DH patient died from adenocarcinoma, but no lymphoma developed in any of the patients. This study documents for the first time refractory DH, in which the rash is non-responsive to a gluten-free diet, but the small bowel mucosa heals. This differs from refractory coeliac disease, in which the small bowel mucosa does not heal on a gluten-free diet. en
dc.format.extent 5
dc.language.iso eng
dc.relation.ispartof Acta Dermato-Venereologica
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject dermatitis herpetiformis
dc.subject coeliac disease
dc.subject small bowel mucosa
dc.subject gluten-free diet
dc.subject dapsone
dc.subject CELIAC-DISEASE
dc.subject SKIN-LESIONS
dc.subject LYMPHOCYTES
dc.subject WITHDRAWAL
dc.subject LYMPHOMA
dc.subject IGA
dc.subject 3121 General medicine, internal medicine and other clinical medicine
dc.title Dermatitis Herpetiformis Refractory to Gluten-free Dietary Treatment en
dc.type Article
dc.contributor.organization Research Programs Unit
dc.contributor.organization Päivi Marjaana Saavalainen / Principal Investigator
dc.contributor.organization Department of Medical and Clinical Genetics
dc.contributor.organization Immunobiology Research Program
dc.contributor.organization Medicum
dc.contributor.organization Immunomics
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.2340/00015555-2184
dc.relation.issn 0001-5555
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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