Dermatitis Herpetiformis: Novel Perspectives

Dermatitis herpetiformis (DH) is an inflammatory disease of the skin, considered the specific cutaneous manifesta¬tion of celiac disease (CD). Both DH and CD occur in gluten-sensitive individuals, share the same Human Leukocyte Antigen (HLA) haplotypes (DQ2 and DQ8), and improve following the adminis¬tration of a gluten-free diet. Moreover, almost all DH patients show typical CD alterations at the small bowel biopsy, ranging from villous atrophy to augmented presence of intraepithelial lymphocytes, and the generation of circulating autoantibodies against tissue transglutaminase (tTG). DH presents with polymorphic lesions, including papules, vesicles and small blisters, symmetrically distributed in typical areas including the extensor aspects of the limbs, elbows, sacral regions and the buttocks. Intense pruritus is almost the rule. However, many atypical presentations of DH have also been reported. Recent evidences suggested that DH is changing. Firstly, some studies reported a reduced incidence of DH, probably due to early recognition of CD, so that there is not enough time for DH to develop. Moreover, data from Japanese literature highlighted the absence of intestinal involvement as well as of the typical serological markers of CD (i.e. anti-tTG antibodies) in Japanese patients with DH. Similar cases may also occur in Caucasian patients, complicating DH diagnosis. The latter relies on the combination of clinical, histopathologic and immunopathologic findings. D...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research

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Conclusion: The incidence of hip fracture is not increased in treated DH or coeliac disease in an area with high awareness and dietary compliance rates. However, patients with DH seem to have a lower risk for fractures overall compared to coeliac disease. PMID: 31280614 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
Abstract: Dermatitis herpetiformis is a rare, chronic autoimmune disorder characterized by intense pruritic papules and vesicles, which can be associated with celiac disease and other autoimmune disorders. Its histologic characteristic is the accumulation of neutrophils within the papillary dermis with granular deposition of immunoglobulin A (IgA) observed under direct immunofluorescence. Herein, we report a 58-year-old woman who presented with a vesicular rash on the buttocks. The patient reported a recent history of genital herpes, Entamoeba histolytica colitis, recurrent hives, and eczema. A representative biopsy demo...
Source: The American Journal of Dermatopathology - Category: Pathology Tags: Extraordinary Case Report Source Type: research
We describe the case of a young boy affected by coeliac disease who, after an occasional unexpected ingestion of gluten, experienced a complete anaphylactic reaction characterized by urticarial, labial angioedema, wheezing, and hypotension. To better investigate the state of allergic sensitization to wheat in our patient, we then performed the component resolved diagnosis, which showed Tri a19 2 kU/l and Tri a14 0.3 kU/l. These results demonstrated the association of IgE-mediated allergy to wheat and coeliac disease. The natural course of specific IgE in allergic patients who are on a food-free diet needs fur...
Source: European Journal of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Case Report Source Type: research
Abstract: Dermatitis herpetiformis and linear IgA bullous dermatosis are autoimmune diseases that present with pruritic urticarial papules and plaques, with formation of vesicles and blisters of subepidermal location, mediated by IgA antibodies. Mucosal lesions are present only in linear IgA bullous dermatosis. The elaboration of this consensus consisted of a brief presentation of the different aspects of these dermatoses and, above all, of an updated literature review on the various therapeutic options that were discussed and compared with the authors ’ experience, aiming at the treatment orientation of these diseas...
Source: Anais Brasileiros de Dermatologia - Category: Dermatology Source Type: research
Abstract Background and objectives: Dermatitis herpetiformis (DH) is a blistering dermatosis, which shares common immunologic features with celiac disease (CD). The aim of the present study was to explore the performance of a panel of CD-related antibodies and IL-17A in Bulgarian patients with DH. Materials and Methods: Serum samples from 26 DH patients at mean age 53 ± 15 years and 20 healthy controls were assessed for anti-tissue transglutaminase (anti-tTG), anti-deamidated gliadin peptides (anti-DGP), anti-actin antibodies (AAA), and IL-17A by enzyme linked immuno-sorbent assay (ELISA), as well as anti-t...
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
Dermatitis herpetiformis (DH) is an extra-intestinal manifestation of coeliac disease causing an itchy, blistering rash. Skin IgA deposits are pathognomonic for DH, and the treatment of choice is a life-long gluten-free diet (GFD). Preliminary evidence suggests that there are DH patients who redevelop gluten tolerance after adherence to a GFD treatment. To examine this, we performed a 12-month gluten challenge with skin and small bowel mucosal biopsies in 19 DH patients who had adhered to a GFD for a mean of 23 years.
Source: Journal of Investigative Dermatology - Category: Dermatology Authors: Tags: Original Article Source Type: research
Dermatitis herpetiformis (DH) is an extraintestinal manifestation of celiac disease causing an itchy, blistering rash. Granular IgA deposits in the skin are pathognomonic for DH, and the treatment of choice is a lifelong gluten-free diet (GFD). Preliminary evidence suggests that there are patients with DH who redevelop gluten tolerance after adherence to a GFD treatment. To evaluate this, we performed a 12-month gluten challenge with  skin and small-bowel mucosal biopsy samples in 19 patients with DH who had adhered to a GFD for a mean of 23 years.
Source: Journal of Investigative Dermatology - Category: Dermatology Authors: Tags: Original Article Source Type: research
Authors: Juratli HA, Görög A, Sárdy M Abstract Dermatitis herpetiformis (DH) is a genetically determined, gluten sensitive autoimmune bullous dermatosis related to celiac disease in which granular, insoluble aggregates in the papillary dermis of epidermal transglutaminase (TG3), immunoglobulin A (IgA), and fibrinogen are present. Detection of the dermal IgA-TG3 immune complex is the gold standard of diagnosis. DH develops in a subpopulation of patients with gluten sensitive enteropathy, characterized by itching, erythematous, excoriated papules showing characteristic distribution ove...
Source: Der Hautarzt: Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete - Category: Dermatology Tags: Hautarzt Source Type: research
Because it has become such a frequent item in everyday meals, suggesting that something so commonplace must be fine, people often ask: Is wheat really that bad? Let’s therefore catalog the health conditions that are associated with wheat consumption. Health conditions we know with 100% certainty are caused by consumption of wheat and related grains: Celiac disease, dermatitis herpetiformis, cerebellar ataxia, “idiopathic” peripheral neuropathy, temporal lobe seizures, gluten encephalopathy, type 1 diabetes, rheumatoid arthritis, autoimmune hepatitis, autoimmune pancreatitis, tooth decay Health conditions ...
Source: Wheat Belly Blog - Category: Cardiology Authors: Tags: News & Updates autoimmune diabetes gluten-free grain-free grains wheat wheat belly Source Type: blogs
ABSTRACT BACKGROUND: Up to 15% of other immune-mediated diseases (IMDs) can occur in patients with CD throughout their lives and are associated with multiple factors, including sex and sex hormone levels. Moreover, sex is associated with differences in clinical presentation, onset, progression, and outcomes of disorders. OBJECTIVE: To investigate the prevalence of IMDs at diagnosis in patients with celiac disease (CD) and their first-degree relatives and to compare the findings between female and male patients of different age. METHODS: A retrospective study including Brazilian patients with CD who visited the same doctor ...
Source: Arquivos de Gastroenterologia - Category: Gastroenterology Source Type: research
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