Prognosis of Dermatitis Herpetiformis Patients with and without Villous Atrophy at Diagnosis
by
Eriika Mansikka 1,2, Kaisa Hervonen 1,2, Katri Kaukinen 2,3, Pekka Collin 4, Heini Huhtala 5
, Timo Reunala 1,2 and Teea Salmi 1,2,*
Eriika Mansikka 1,2, Kaisa Hervonen 1,2, Katri Kaukinen 2,3, Pekka Collin 4, Heini Huhtala 5, Timo Reunala 1,2 and Teea Salmi 1,2,*
1
Department of Dermatology, Tampere University Hospital, 33521 Tampere, Finland
2
Celiac Disease Research Center, Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
3
Department of Internal Medicine, Tampere University Hospital, 33521 Tampere, Finland
4
Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, 33521 Tampere, Finland
5
Faculty of Social Sciences, University of Tampere, 33014 Tampere, Finland
*
Author to whom correspondence should be addressed.
Nutrients 2018, 10(5), 641; https://doi.org/10.3390/nu10050641
Received: 18 April 2018 / Revised: 11 May 2018 / Accepted: 15 May 2018 / Published: 19 May 2018
(This article belongs to the Special Issue Extraintestinal Manifestations of Coeliac Disease)
Dermatitis herpetiformis (DH) is a cutaneous manifestation of coeliac disease. At diagnosis, the majority of patients have villous atrophy in the small bowel mucosa. The objective of this study was to investigate whether the presence or absence of villous atrophy at diagnosis affects the long-term prognosis of DH. Data were gathered from the patient records of 352 DH and 248 coeliac disease patients, and follow-up data via questionnaires from 181 DH and 128 coeliac disease patients on a gluten-free diet (GFD). Of the DH patients, 72% had villous atrophy when DH was diagnosed, and these patients were significantly younger at diagnosis compared to those with normal small bowel mucosa (37 vs. 54 years, p < 0.001). Clinical recovery on a GFD did not differ significantly between the DH groups, nor did current adherence to a GFD, the presence of long-term illnesses, coeliac disease-related complications or gastrointestinal symptoms, or quality of life. By contrast, the coeliac disease controls had more often osteopenia/osteoporosis, thyroid diseases, malignancies and current gastrointestinal symptoms compared to the DH patients. In conclusion, villous atrophy at the time of DH diagnosis does not have an impact on the clinical recovery or long-term general health of DH patients.
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Keywords:
dermatitis herpetiformis; coeliac disease; gluten-free diet; small bowel; villous atrophy; prognosis
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MDPI and ACS Style
Mansikka, E.; Hervonen, K.; Kaukinen, K.; Collin, P.; Huhtala, H.; Reunala, T.; Salmi, T. Prognosis of Dermatitis Herpetiformis Patients with and without Villous Atrophy at Diagnosis. Nutrients 2018, 10, 641.
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