title: Chronic gastritis in dermatitis herpetiformis: a controlled study.
abstract: OBJECTIVE
  Previous small studies suggest that chronic atrophic gastritis is common in dermatitis herpetiformis (DH). We here examined the frequency and topography of chronic gastritis in 93 untreated DH subjects and in 186 controls with dyspepsia.
  
  
  METHODS
  Specimens were drawn from the gastric corpus and antrum and examined for atrophy, intestinal metaplasia, and Helicobacter pylori. Duodenal biopsies were taken.
  
  
  RESULTS
  Atrophic corpus gastritis was more frequent in DH than in controls (16.0% and 2.7%, resp., P < 0.001); atrophy in the antrum was rare in both groups (3.2% and 1.1%, P = 0.34). Intestinal metaplasia was present in 13 (14.0%) DH and 12 (6.5%) control patients (P = 0.038) and H. pylori in 17 (18.3%) and 17 (9.3%) (P = 0.028), respectively. Small-bowel villous atrophy was seen in 76% of the DH patients, equally in patients with and without chronic gastritis. One DH patient with atrophic gastritis developed gastric cancer.
  
  
  CONCLUSIONS
  In DH, chronic atrophic gastritis was common in the corpus, but not in the antrum. H. pylori will partly explain this, but corpus atrophy is suggestive of an autoimmune etiology. Atrophic gastritis may increase the risk of gastric cancer. We advocate performing upper endoscopy with sufficient histologic samples in DH.
authors.affiliation: Department of Dermatology, Tampere University Hospital, 33521 Tampere, Finland.
authors.forename: Anna
authors.initials: A
authors.lastname: Alakoski
authors.forename: Teea T
authors.initials: TT
authors.lastname: Salmi
authors.forename: Kaisa
authors.initials: K
authors.lastname: Hervonen
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.forename: Maarit
authors.initials: M
authors.lastname: Salo
authors.forename: Katri
authors.initials: K
authors.lastname: Kaukinen
authors.forename: Timo
authors.initials: T
authors.lastname: Reunala
authors.forename: Pekka
authors.initials: P
authors.lastname: Collin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015551:Autoimmunity; D002648:Child; D002908:Chronic Disease; D003874:Dermatitis Herpetiformis / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D005387:Finland; D005756:Gastritis / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D041981:Gastrointestinal Tract / Q000382:microbiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult