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THE MANAGEMENT OF DERMATITIS HERPETIFORMIS BY THE GASTROENTEROLOGIST. A SERIES OF CASES

Authors :
Lorete Maria da Silva KOTZE
Luiz Roberto KOTZE
Katia Sheylla Malta PURIM
Renato NISIHARA
Source :
Arquivos de Gastroenterologia, Vol 58, Iss 4, Pp 429-432 (2021)
Publication Year :
2021
Publisher :
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE), 2021.

Abstract

ABSTRACT BACKGROUND: Dermatitis herpetiformis (DH) is considered a skin celiac disease (CD). The individuals can be seen by primary care professionals or by dermatologists that could refer the patient to a gastroenterologist. OBJECTIVE: The study aimed to investigate the clinical profile of patients diagnosed with DH and referred to a gastroenterologist and evaluate the treatment response. METHODS: We retrospectively studied patients with DH referred to the same gastroenterologist at a private office in Curitiba, Brazil, between January 2010 to December 2019. We included adult patients with a confirmed DH diagnosis. Symptoms, clinical signs, laboratory and histological data, as well as treatment response, were collected. RESULTS: Thirty-three patients were studied (60.6% women, mean age at diagnosis 40.8±12.61 years). The median delay for DH diagnosis was four years. Skin involvement was mild in 33.3%, moderate in 18.2%, and severe in 48.5%. The more frequent gastrointestinal complaints were abdominal distension (78.8%), flatulence (75.7%), and gastroesophageal reflux (51.5%). Depression and anxiety were observed in 81.8% and anemia in 51.1%. A higher prevalence of bone disorders was associated with higher age at DH diagnosis (P=0.035). Duodenal biopsy showed changes in all patients. Improvement after treatment only with a gluten-free diet (GFD) plus dapsone was verified in 81.2%. CONCLUSION: Patients with DH referred to a gastroenterologist showed a high frequency of gluten intolerance and systemic complaints. Duodenal histological alterations were found in all the cases. The treatment based on GFD plus dapsone was effective in most patients.

Details

Language :
English
ISSN :
16784219 and 00042803
Volume :
58
Issue :
4
Database :
Directory of Open Access Journals
Journal :
Arquivos de Gastroenterologia
Publication Type :
Academic Journal
Accession number :
edsdoj.469fdfbdca1349c39d25b42cbd3730a7
Document Type :
article
Full Text :
https://doi.org/10.1590/s0004-2803.202100000-78