Quality of Life and Gastrointestinal Symptoms in Long-Term Treated Dermatitis Herpetiformis Patients: A Cross-Sectional Study in Finland.
BACKGROUND
Dermatitis herpetiformis (DH) is a cutaneous manifestation of celiac disease. Both conditions are treated with a restrictive life-long gluten-free diet (GFD). Treated celiac disease patients have been shown to have more severe gastrointestinal symptoms and inferior quality of life compared with healthy controls, but evidence regarding quality of life in DH is lacking.


OBJECTIVE
The aim was to evaluate whether long-term GFD-treated DH patients suffer from persistent gastrointestinal symptoms and if they experience a drawdown in quality of life.


METHODS
Gastrointestinal symptoms and quality of life were assessed in 78 long-term GFD-treated DH patients using the validated Gastrointestinal Symptom Rating Scale, Psychological General Well-Being and Short Form 36 Health Survey questionnaires. The findings were compared with 110 healthy controls, population-based reference values and 371 treated celiac disease controls.


RESULTS
The median age of the DH patients at the time of the study was 57 years, and 51 % were male. Significant differences in gastrointestinal symptoms or quality of life were not detected when treated DH patients were compared with healthy controls, but treated DH patients had less severe gastrointestinal symptoms and increased quality of life compared with celiac disease controls. Female DH patients had more severe gastrointestinal symptoms and reduced vitality compared with male DH patients. The presence of skin symptoms and the adherence to or duration of GFD did not have any influence on gastrointestinal symptoms or quality of life.


CONCLUSIONS
We conclude that long-term GFD-treated DH patients do not suffer from the burden of dietary treatment and have a quality of life comparable to that of controls.
School of Medicine, University of Tampere, Tampere, Finland.
Camilla
C
Pasternack
School of Medicine, University of Tampere, Tampere, Finland.|Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.|Department of Internal Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland.
Katri
K
Kaukinen
Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
Kalle
K
Kurppa
Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
Markku
M
Mäki
Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
Pekka
P
Collin
School of Medicine, University of Tampere, Tampere, Finland.|Department of Dermatology, Tampere University Hospital, PO.Box 2000, 33521, Tampere, Finland.
Timo
T
Reunala
Tampere School of Health Sciences, University of Tampere, Tampere, Finland.
Heini
H
Huhtala
School of Medicine, University of Tampere, Tampere, Finland. teea.salmi@uta.fi.|Department of Dermatology, Tampere University Hospital, PO.Box 2000, 33521, Tampere, Finland. teea.salmi@uta.fi.
Teea
T
Salmi
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002446:Celiac Disease / Q000178:diet therapy* / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003874:Dermatitis Herpetiformis / Q000175:diagnosis / Q000178:diet therapy* / Q000453:epidemiology* / Q000523:psychology; D055050:Diet, Gluten-Free; D042241:Early Diagnosis; D005260:Female; D005387:Finland; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome; D055815:Young Adult