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Dermatitis Herpetiformis: The Role of Gluten

Dermatitis Herpetiformis: The Role of Gluten Abstract About two thirds of the patients with dermatitis herpetiformis have an enteropathy which responds to treatment with a gluten-free diet. By contrast, their rash is totally unaffected by gluten withdrawal. Likewise, the rash is unaffected by gluten withdrawal in patients with dermatitis herpetiformis who have a normal bowel. Intradermal injection of gluten does not provoke the rash. The significance of the dose of dapsone required to control the rash is discussed. The minimal effective dose of dapsone is in most patients unaffected by gluten withdrawal. The relationship of the enteropathy to the rash is an indirect one and patients whose enteropathy is controlled by a gluten-free diet will still need dapsone for their rash. References 1. Marks J, Shuster S, Watson AJ: Small-bowel changes in dermatitis herpetiformis . Lancet 2:1280-1282, 1966.Crossref 2. Van Tongeren JHM, Van der Staak WJBM, Schillings PHM: Small-bowel changes in dermatitis herpetiformis . Lancet 1:218, 1967.Crossref 3. Fry L, et al: Small-intestinal structure and function and haematological changes in dermatitis herpetiformis . Lancet 2:729-733, 1967.Crossref 4. Marks R, et al: Small-bowel abnormalities in dermatitis herpetiformis . Brit Med J 1:552-555, 1968.Crossref 5. Bendl BJ, Williams PB: Histopathological changes in the jejunal mucosa in dermatitis herpetiformis . Canad Med Assoc J 98:575-577, 1968. 6. Shuster S, Watson AJ, Marks J: Coeliac syndrome in dermatitis herpetiformis . Lancet 1:1101-1106, 1968.Crossref 7. Brow JR, Parker F, Rubin CE: Coeliac sprue and the sprue-like lesion of dermatitis herpetiformis: Separate or related entities ? Gastroenterology 54:1223, 1968. 8. Shuster S: Systemic effects of skin disease . Lancet 1:907-912, 1967.Crossref 9. Shuster S: Skin diseases and malabsorption: A reappraisal , in the Third Symposium on Advanced Medicine, Royal College of Physicians . London, Pitman Publishing Co, 1967, pp 349-361. 10. Shuster S, Marks J: Systemic Effects of Skin Disease . London, William Heinemann Ltd, to be published. 11. Shuster S, Marks J: Dermatogenic enteropathy: A new cause of steatorrhoea . Lancet 1:1367-1368, 1965.Crossref 12. Fry L, et al: Effect of gluten-free diet on dermatological, intestinal and haematological manifestations of dermatitis herpetiformis . Lancet 1:557-561, 1968.Crossref 13. Marks J, Shuster S: Malabsorption and the skin . Brit Med J 4:455, 1968.Crossref 14. Crosby WH, Kugler HW: Intraterminal biopsy of the small intestine . Amer J Dig Dis 2:236-241, 1957.Crossref 15. Stewart JS, et al: A study of proximal and distal intestinal structure and absorption function in idiopathic steatorrhoea . Quart J Med 36:425-444, 1967. 16. Marks J, Shuster S: Small-intestinal mucosal abnormalities in various dermatoses: Fact or fancy . Gut , to be published. 17. Fraser NG, Ferguson A, Murray D: Dermatitis herptiformis in two patients with idiopathic steatorrhoea (adult coeliac disease) . Brit Med J 4:30-31, 1968.Crossref 18. Marks R: Dermatitis herpetiformis and the gastro-intestinal tract . Trans St John Hosp Derm Soc 54:141-147, 1968. 19. Fraser NG, Murray D, Alexander JO: Structure and function of the small intestine in dermatitis herpetiformis . Brit J Derm 79:509-518, 1967.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Dermatitis Herpetiformis: The Role of Gluten

Marks, Janet; Shuster, Sam
Archives of Dermatology , Volume 101 (4) – Apr 1, 1970
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References (17)

Publisher
American Medical Association
Copyright
Copyright © 1970 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1970.04000040074014
Publisher site
See Article on Publisher Site

Abstract

Abstract About two thirds of the patients with dermatitis herpetiformis have an enteropathy which responds to treatment with a gluten-free diet. By contrast, their rash is totally unaffected by gluten withdrawal. Likewise, the rash is unaffected by gluten withdrawal in patients with dermatitis herpetiformis who have a normal bowel. Intradermal injection of gluten does not provoke the rash. The significance of the dose of dapsone required to control the rash is discussed. The minimal effective dose of dapsone is in most patients unaffected by gluten withdrawal. The relationship of the enteropathy to the rash is an indirect one and patients whose enteropathy is controlled by a gluten-free diet will still need dapsone for their rash. References 1. Marks J, Shuster S, Watson AJ: Small-bowel changes in dermatitis herpetiformis . Lancet 2:1280-1282, 1966.Crossref 2. Van Tongeren JHM, Van der Staak WJBM, Schillings PHM: Small-bowel changes in dermatitis herpetiformis . Lancet 1:218, 1967.Crossref 3. Fry L, et al: Small-intestinal structure and function and haematological changes in dermatitis herpetiformis . Lancet 2:729-733, 1967.Crossref 4. Marks R, et al: Small-bowel abnormalities in dermatitis herpetiformis . Brit Med J 1:552-555, 1968.Crossref 5. Bendl BJ, Williams PB: Histopathological changes in the jejunal mucosa in dermatitis herpetiformis . Canad Med Assoc J 98:575-577, 1968. 6. Shuster S, Watson AJ, Marks J: Coeliac syndrome in dermatitis herpetiformis . Lancet 1:1101-1106, 1968.Crossref 7. Brow JR, Parker F, Rubin CE: Coeliac sprue and the sprue-like lesion of dermatitis herpetiformis: Separate or related entities ? Gastroenterology 54:1223, 1968. 8. Shuster S: Systemic effects of skin disease . Lancet 1:907-912, 1967.Crossref 9. Shuster S: Skin diseases and malabsorption: A reappraisal , in the Third Symposium on Advanced Medicine, Royal College of Physicians . London, Pitman Publishing Co, 1967, pp 349-361. 10. Shuster S, Marks J: Systemic Effects of Skin Disease . London, William Heinemann Ltd, to be published. 11. Shuster S, Marks J: Dermatogenic enteropathy: A new cause of steatorrhoea . Lancet 1:1367-1368, 1965.Crossref 12. Fry L, et al: Effect of gluten-free diet on dermatological, intestinal and haematological manifestations of dermatitis herpetiformis . Lancet 1:557-561, 1968.Crossref 13. Marks J, Shuster S: Malabsorption and the skin . Brit Med J 4:455, 1968.Crossref 14. Crosby WH, Kugler HW: Intraterminal biopsy of the small intestine . Amer J Dig Dis 2:236-241, 1957.Crossref 15. Stewart JS, et al: A study of proximal and distal intestinal structure and absorption function in idiopathic steatorrhoea . Quart J Med 36:425-444, 1967. 16. Marks J, Shuster S: Small-intestinal mucosal abnormalities in various dermatoses: Fact or fancy . Gut , to be published. 17. Fraser NG, Ferguson A, Murray D: Dermatitis herptiformis in two patients with idiopathic steatorrhoea (adult coeliac disease) . Brit Med J 4:30-31, 1968.Crossref 18. Marks R: Dermatitis herpetiformis and the gastro-intestinal tract . Trans St John Hosp Derm Soc 54:141-147, 1968. 19. Fraser NG, Murray D, Alexander JO: Structure and function of the small intestine in dermatitis herpetiformis . Brit J Derm 79:509-518, 1967.Crossref

Journal

Archives of Dermatology – American Medical Association

Published: Apr 1, 1970

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