title: Cutaneous Manifestations of Non-Celiac Gluten Sensitivity: Clinical Histological and Immunopathological Features.
abstract: BACKGROUND
  The dermatological manifestations associated with intestinal diseases are becoming more frequent, especially now when new clinical entities, such as Non-Celiac Gluten Sensitivity (NCGS), are identified. The existence of this new entity is still debated. However, many patients with diagnosed NCGS that present intestinal manifestations have skin lesions that need appropriate characterization.
  
  
  METHODS
  We involved 17 patients affected by NCGS with non-specific cutaneous manifestations who got much better after a gluten free diet. For a histopathological and immunopathological evaluation, two skin samples from each patient and their clinical data were collected.
  
  
  RESULTS
  The median age of the 17 enrolled patients affected by NCGS was 36 years and 76% of them were females. On the extensor surfaces of upper and lower limbs in particular, they all presented very itchy dermatological manifestations morphologically similar to eczema, psoriasis or dermatitis herpetiformis. This similarity was also confirmed histologically, but the immunopathological analysis showed the prevalence of deposits of C3 along the dermo-epidermal junction with a microgranular/granular pattern (82%).
  
  
  CONCLUSIONS
  The exact characterization of new clinical entities such as Cutaneous Gluten Sensitivity and NCGS is an important objective both for diagnostic and therapeutic purposes, since these are patients who actually benefit from a GFD (Gluten Free Diet) and who do not adopt it only for fashion.
authors.affiliation: Department of Surgery and Translational Medicine, Section of Dermatology, University of Florence, Viale Michelangiolo 41, Florence 50125, Italy. vbonciolini@gmail.com.
authors.forename: Veronica
authors.initials: V
authors.lastname: Bonciolini
authors.affiliation: Department of Surgery and Translational Medicine, Section of Dermatology, University of Florence, Viale Michelangiolo 41, Florence 50125, Italy. beatrice.bianchi@unifi.com.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Bianchi
authors.affiliation: Department of Surgery and Translational Medicine, Section of Dermatology, University of Florence, Viale Michelangiolo 41, Florence 50125, Italy. elena.delbianco@unifi.com.
authors.forename: Elena
authors.initials: E
authors.lastname: Del Bianco
authors.affiliation: Department of Surgery and Translational Medicine, Section of Dermatology, University of Florence, Viale Michelangiolo 41, Florence 50125, Italy. alice.verdelli@hotmail.com.
authors.forename: Alice
authors.initials: A
authors.lastname: Verdelli
authors.affiliation: Director SOS Skin Immunopathology and Rare Dermatological Diseases Unit, 1st Dermatological Clinic ASF-Piero Palagi, Department of Medical and Surgical Critical Care, Section of Dermatology, University of Florence, Viale Michelangiolo 41, Florence 50125, Italy. marzia.caproni@unifi.com.
authors.forename: Marzia
authors.initials: M
authors.lastname: Caproni
mesh_terms: D000328:Adult; D001706:Biopsy; D002446:Celiac Disease / Q000178:diet therapy / Q000276:immunology / Q000473:pathology; D003176:Complement C3 / Q000032:analysis; D003937:Diagnosis, Differential; D055050:Diet, Gluten-Free; D005260:Female; D005983:Glutens / Q000009:adverse effects* / Q000276:immunology; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012074:Remission Induction; D012867:Skin / Q000276:immunology* / Q000473:pathology*; D012871:Skin Diseases / Q000178:diet therapy / Q000276:immunology* / Q000473:pathology*; D016896:Treatment Outcome; D021182:Wheat Hypersensitivity / Q000145:classification / Q000178:diet therapy / Q000276:immunology* / Q000473:pathology*
chemical_list: C038245:C3 protein, human; D003176:Complement C3; D005983:Glutens
keywords: cutaneous gluten sensitivity; direct immunofluorescence; non-celiac gluten sensitivity; skin manifestations