title: A long-term gluten-free diet as an alternative treatment in severe forms of dermatitis herpetiformis.
abstract: BACKGROUND
  A long-term gluten-free diet (GFD) as a first-choice treatment for dermatitis herpetiformis (DH) has been used successfully. The aim of the present study is to evaluate the possibility of treating all severe skin manifestations of DH by a GFD only.
  
  
  METHODS
  Seventy-two patients with DH were subdivided in two groups: group A (18 patients) underwent a GFD and received dapsone; group B (54 patients) underwent a GFD. Patients were subdivided into slight, moderate and severe forms.
  
  
  RESULTS
  A total of 88.9% of patients treated with dapsone and a GFD (group A) had remission of skin manifestations and the remaining 11.1% were improved. In group B, 87% of patients showed complete remission of skin manifestations after 18 months of a GFD; 13% showed improvement. With regard to severe forms, after an 18-month treatment, 70.4% of patients in group B; 66.6% in group A.
  
  
  CONCLUSIONS
  Our study shows that a GFD, if administered steadily and for a long period, can be a valid treatment for severe forms of DH. Dapsone can be useful to control the inflammatory phase of the disease.
authors: Department of Dermatology, University 'Federico II' of Naples, Naples, Italy. massimilianonino@yahoo.it
authors: Massimiliano
authors: M
authors: Nino
authors: Carolina
authors: C
authors: Ciacci
authors: Mario
authors: M
authors: Delfino
mesh_terms: D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002446:Celiac Disease / Q000178:diet therapy; D002648:Child; D003622:Dapsone / Q000627:therapeutic use; D003874:Dermatitis Herpetiformis / Q000178:diet therapy* / Q000188:drug therapy; D005260:Female; D005983:Glutens / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005983:Glutens; D003622:Dapsone