title: Long term follow-up of dermatitis herpetiformis with and without dietary gluten withdrawal.
abstract: Seventy-eight patients with dermatitis herpetiformis have been followed up for periods ranging from 3 to 14 years (mean 7.4). Forty-two patients were treated with gluten-free diet (GFD) and thirty-six took a normal diet (ND). Thirty of the forty-two (71%) taking the GFD were able to discontinue drugs previously needed to control their rash compared with five (14%) of the thirty-six patients taking a ND. The mean time taken to reduce drug requirements for patients taking a GFD was 8 months (range 4-30), and for stopping drugs, 29 months (range 6-108). The incidence of macroscopic abnormality of the small intestine decreased from 69 to 15%, and the mean intra-epithelial lymphocyte count decreased significantly in those patients taking a GFD, whereas there was no significant change in patients taking a ND. The improvement in the skin and intestinal lesions was related to the strictness of the GFD.
mesh_terms: D000293:Adolescent; D000328:Adult; D003622:Dapsone / Q000008:administration & dosage / Q000009:adverse effects; D003874:Dermatitis Herpetiformis / Q000178:diet therapy* / Q000188:drug therapy / Q000473:pathology; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005983:Glutens; D006801:Humans; D007070:Immunoglobulin A / Q000378:metabolism; D007422:Intestines / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000276:immunology; D013997:Time Factors
chemical_list: D007070:Immunoglobulin A; D005983:Glutens; D003622:Dapsone