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Dermatologie (Heidelberg, Germany) Sep 2022Autoimmune bullous diseases (AIBD) comprise a group of organ-specific autoimmune diseases which are characterised by the production of autoantibodies against adhesion... (Review)
Review
Autoimmune bullous diseases (AIBD) comprise a group of organ-specific autoimmune diseases which are characterised by the production of autoantibodies against adhesion molecules and structural proteins of skin and mucosae. Depending on the target protein, AIBD are classified into intraepidermal (pemphigus group) and subepidermal (pemphigoid group, epidermolysis bullosa acquisita, dermatitis herpetiformis) blistering disorders. Depending on the clinical entity, patients can develop blisters, pustules, erosions, and erythema on the skin and mucosae.
Topics: Autoimmune Diseases; Blister; Epidermolysis Bullosa Acquisita; Humans; Mucous Membrane; Pemphigoid, Bullous; Skin Diseases, Vesiculobullous
PubMed: 36006424
DOI: 10.1007/s00105-022-05036-y -
United European Gastroenterology Journal Apr 2015A gluten-free diet (GFD) is currently the only available therapy for coeliac disease (CD). (Review)
Review
BACKGROUND
A gluten-free diet (GFD) is currently the only available therapy for coeliac disease (CD).
OBJECTIVES
We aim to review the literature on the GFD, the gluten content in naturally gluten-free (GF) and commercially available GF food, standards and legislation concerning the gluten content of foods, and the vitamins and mineral content of a GFD.
METHODS
We carried out a PubMed search for the following terms: Gluten, GFD and food, education, vitamins, minerals, calcium, Codex wheat starch and oats. Relevant papers were reviewed and for each topic a consensus among the authors was obtained.
CONCLUSION
Patients with CD should avoid gluten and maintain a balanced diet to ensure an adequate intake of nutrients, vitamins, fibre and calcium. A GFD improves symptoms in most patients with CD. The practicalities of this however, are difficult, as (i) many processed foods are contaminated with gluten, (ii) staple GF foods are not widely available, and (iii) the GF substitutes are often expensive. Furthermore, (iv) the restrictions of the diet may adversely affect social interactions and quality of life. The inclusion of oats and wheat starch in the diet remains controversial.
PubMed: 25922672
DOI: 10.1177/2050640614559263 -
Journal of the European Academy of... Sep 2019Autoimmune Blistering Diseases of the Pemphigoid type is characterised by sub-epidermal blisters (SEB) with circulating autoantibodies against components of the basement... (Review)
Review
Autoimmune Blistering Diseases of the Pemphigoid type is characterised by sub-epidermal blisters (SEB) with circulating autoantibodies against components of the basement membrane zone (BMZ). The main disorders to date include bullous pemphigoid (BP), pemphigoid gestationis, mucous membrane pemphigoid (MMP), epidermolysis bullosa acquisita (EBA), linear IgA disease (LABD), dermatitis herpetiformis (DH), lichen planus pemphigoides and bullous lupus. This is in contrast to pemphigus and related disorders, which demonstrate intraepidermal acantholysis and a positive Nikolsky sign. The classification and management is based on clinical, histological and direct and indirect immunofluorescence findings. There are, however, overlapping clinical and histological features between the conditions and clinical heterogeneity within each disease.
Topics: Autoimmune Diseases; Humans; Skin Diseases, Vesiculobullous
PubMed: 31087464
DOI: 10.1111/jdv.15679 -
Dermatology Online Journal Dec 2014Dermatitis herpetiformis (DH) is an autoimmune bullous disease, which represents the cutaneous manifestation of gluten sensitivity, in the setting of celiac disease....
Dermatitis herpetiformis (DH) is an autoimmune bullous disease, which represents the cutaneous manifestation of gluten sensitivity, in the setting of celiac disease. Although classical DH is characterized clinically by grouped, vesicles on an erythematous base, primary lesions often are absent owing to the intense, associated pruritus. Instead, many cases present only with erythematous erosions with numerous overlying excoriations. As in celiac disease, the core pathogenic mechanisms of DH are likely mediated by immunoglobulin A class autoantibodies against one of several transglutaminase enzymes. As the production of these autoantibodies is directly correlated with gastrointestinal exposure to gliadin, which is an alcohol-soluble fraction of gluten, a gluten-free diet represents the cornerstone of a DH management regimen. In cases refractory to dietary management alone, dapsone is the first-line agent for the treatment of DH, although many other agents have been anecdotally reported as effective.
Topics: Celiac Disease; Dermatitis Herpetiformis; Humans; Male; Middle Aged
PubMed: 25526342
DOI: No ID Found -
Cureus Sep 2022Dermatitis herpetiformis (DH) is an auto-inflammatory skin disease that is linked to gluten sensitivity and is related to celiac disease (CD). Psoriasis is an...
Dermatitis herpetiformis (DH) is an auto-inflammatory skin disease that is linked to gluten sensitivity and is related to celiac disease (CD). Psoriasis is an inflammatory skin disorder found to have an association with the celiac disease, according to various genetic and epidemiological studies. We report a 12-year-girl who presented with multiple tense blisters along with red raised, scaly and itchy lesions over her body. She was a known case of psoriasis and was diagnosed as dermatitis herpetiformis in an immunofluorescence study. In this case report, we want to highlight the fact that the co-existence of dermatitis herpetiformis and psoriasis could be more than a mere coincidence. In our patient's previously uncontrolled psoriasis and dermatitis herpetiformis both improved after a gluten-free diet along with systemic therapy.
PubMed: 36258965
DOI: 10.7759/cureus.29218 -
Journal of Clinical Medicine Jun 2022Autoimmune bullous skin disorders are a group of disorders characterized by the formation of numerous blisters and erosions on the skin and/or the mucosal membrane,... (Review)
Review
Autoimmune bullous skin disorders are a group of disorders characterized by the formation of numerous blisters and erosions on the skin and/or the mucosal membrane, arising from autoantibodies against the intercellular adhesion molecules and the structural proteins. They can be classified into intraepithelial or subepithelial autoimmune bullous dermatoses based on the location of the targeted antigens. These dermatoses are extremely debilitating and fatal in certain cases, depending on the degree of cutaneous and mucosal involvement. Effective treatments should be implemented promptly. Glucocorticoids serve as the first-line approach due to their rapid onset of therapeutic effects and remission of the acute phase. Nonetheless, long-term applications may lead to major adverse effects that outweigh the benefits. Hence, other adjuvant therapies are mandatory to minimize the potential harm and ameliorate the quality of life. Herein, we summarize the current therapeutic strategies and introduce promising therapies for intractable autoimmune bullous diseases.
PubMed: 35743598
DOI: 10.3390/jcm11123528 -
Journal of the American Academy of... Jul 2021Subepithelial autoimmune blistering dermatoses are a group of rare skin disorders that are characterized by the disruption of the dermal-epidermal junction through the... (Review)
Review
Subepithelial autoimmune blistering dermatoses are a group of rare skin disorders that are characterized by the disruption of the dermal-epidermal junction through the action of autoantibodies. The third article in this continuing medical education series explores the background, epidemiology, clinical features, and diagnostic criteria of each of the major subepithelial autoimmune blistering dermatoses, including bullous pemphigoid, pemphigoid gestationis, lichen planus pemphigoides, mucous membrane pemphigoid, linear IgA bullous dermatosis, and dermatitis herpetiformis.
Topics: Autoimmune Diseases; Dermis; Female; Humans; Lichen Planus; Pemphigoid Gestationis; Pregnancy; Skin Diseases, Vesiculobullous
PubMed: 33684496
DOI: 10.1016/j.jaad.2020.11.076 -
European Journal of Dermatology : EJD Aug 2017The characteristics of patients with dermatitis herpetiformis (DH) in France is poorly documented. Furthermore, the risk of fractures and bone mineral density (BMD) in...
The characteristics of patients with dermatitis herpetiformis (DH) in France is poorly documented. Furthermore, the risk of fractures and bone mineral density (BMD) in DH remain under-described, and recommendations for systematic screening for osteoporosis in DH are lacking. To describe the characteristics of DH in a large French cohort and evaluate the association between BMD and features of osteoporosis. Patients were recruited from the French Association of Gluten Intolerants (AFDIAG) and a single university dermatology department. A telephone questionnaire was used to record features of DH, history of fractures, calcium intake, treatment, and the gluten-free diet (GFD). Serum calcium and 25(OH) vitamin D3+D2 levels, as well as BMD, were measured. We included 53 patients (27 men) with a median age of 49 years (range: 23-86). Median disease duration before inclusion was 14 years (range: 2-55); 51 patients (96%) were adherent to a GFD and had no digestive symptoms. Overall, 18 (34%) had a history of fractures; 16 high-velocity (traumatic) and two low-velocity (non-traumatic). Mean BMD, measured in 48 patients, was normal (femoral neck: 0.956 ± 0.210 g/cm; lumbar spine: 1.091 ± 1.199 g/cm). In all, 18 patients (38%) had osteopenia and one (2%) osteoporosis. T-score for bone density did not differ with and without fractures. Calcium intake and serum calcium level were normal in all patients. Screening for osteoporosis does not appear to be mandatory for DH patients with good adherence to a GFD and without digestive symptoms or additional risk factors of osteoporosis.
Topics: Adult; Aged; Aged, 80 and over; Bone Density; Bone Diseases, Metabolic; Calcium; Calcium, Dietary; Dapsone; Dermatitis Herpetiformis; Diet, Gluten-Free; Female; Folic Acid Antagonists; Fractures, Bone; France; Gastrointestinal Diseases; Humans; Male; Middle Aged; Osteoporosis; Phosphorus; Retrospective Studies; Young Adult
PubMed: 28524056
DOI: 10.1684/ejd.2017.3029 -
Clinics in Dermatology 2016A switch from cell-mediated to humoral immunity (helper T 1 [Th1] to helper T 2 [Th2] shift) during gestation plays a key role in placental immune tolerance. As a... (Review)
Review
A switch from cell-mediated to humoral immunity (helper T 1 [Th1] to helper T 2 [Th2] shift) during gestation plays a key role in placental immune tolerance. As a result, skin diseases that are Th2 mediated often worsen, whereas skin diseases that are Th1 mediated often improve during gestation. Also, due to fluctuations in glandular activity, skin diseases involving sebaceous and eccrine glands may flare, whereas those involving apocrine glands may improve during pregnancy. Despite these trends, inflammatory and glandular skin diseases do not always follow the predicted pattern, and courses are often diverse. We review the gestational course of inflammatory skin diseases, such as atopic dermatitis (atopic eruption of pregnancy), psoriasis, impetigo herpetiformis, urticaria, erythema annulare centrifugum, pityriasis rosea, sarcoidosis, Sweet syndrome, and erythema nodosum, as well as glandular skin diseases, including acne vulgaris, acne rosacea, perioral dermatitis, hidradenitis suppurativa, Fox-Fordyce disease, hyperhidrosis, and miliaria. For each of these diseases, we discuss the pathogenesis, clinical presentation, and management with special consideration for maternal and fetal safety.
Topics: Acne Vulgaris; Dermatitis, Atopic; Dermatitis, Perioral; Erythema Nodosum; Female; Fox-Fordyce Disease; Hidradenitis Suppurativa; Humans; Pityriasis Rosea; Pregnancy; Pregnancy Complications; Psoriasis; Remission, Spontaneous; Rosacea; Sarcoidosis; Skin Diseases; Sweet Syndrome; Symptom Flare Up; Urticaria
PubMed: 27265071
DOI: 10.1016/j.clindermatol.2016.02.005