{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:48:14Z","timestamp":1787161694829,"version":"build-2736575974"},"reference-count":14,"publisher":"BMJ","issue":"6358","license":[{"start":{"date-parts":[[1983,1,1]],"date-time":"1983-01-01T00:00:00Z","timestamp":410227200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J (Clin Res Ed)"],"published-print":{"date-parts":[[1983,1,1]]},"abstract":"<jats:p>A retrospective study of 109 patients with dermatitis herpetiformis showed that malignant tumours had developed in seven patients, the expected incidence being 2.93, giving a relative risk of 2.38. In three of the seven patients the malignancy was a lymphoma, giving a relative risk of 100 for this tumour (expected incidence 0.03). In six of the seven patients who developed malignancies small-intestinal biopsy specimens were macroscopically abnormal, giving a relative risk of 4.22 in this group, which is similar to that reported in adult coeliac disease. Patients treated with a gluten-free diet appeared to have a reduced risk of developing malignancy compared with those taking a normal diet (relative risk with gluten-free diet 1.01 and with normal diet 3.09). A small subgroup of eight patients with linear IgA dermatitis herpetiformis were also studied: three developed malignant disease and in one the tumour was a lymphoma.<\/jats:p>","DOI":"10.1136\/bmj.286.6358.16","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T11:00:59Z","timestamp":1238670059000},"page":"16-18","source":"Crossref","is-referenced-by-count":120,"title":["Increased incidence of malignancy in dermatitis herpetiformis."],"prefix":"10.1136","volume":"286","author":[{"given":"J N","family":"Leonard","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W F","family":"Tucker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J S","family":"Fry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C A","family":"Coulter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A W","family":"Boylston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R M","family":"McMinn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G P","family":"Haffenden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A F","family":"Swain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Fry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1983,1,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/0002-9343(67)90071-X","article-title":"Malignancy in adult coeliac disease and idiopathic steatorrhoea","volume":"42","author":"Harris, O.D.; Cooke, W.T.; Thompson, H.; Waterhouse, J.A.H.","year":"1967","unstructured":"Harris OD, Cooke WT, Thompson H, Waterhouse JAH. Malignancy in adult coeliac disease and idiopathic steatorrhoea. Am J Med 1967;42: 899-912.","journal-title":"Am J Med"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1136\/gut.17.8.612","article-title":"Coeliac disease, gluten free diet and malignancy","volume":"17","author":"Holmes, G.K.T.; Stokes, P.L.; Sorahan, T.M.; Prior, P.; Waterhouse, J.A.H.; Cooke, W.T.","year":"1976","unstructured":"Holmes GKT, Stokes PL, Sorahan TM, Prior P, Waterhouse JAH, Cooke WT. Coeliac disease, gluten free diet and malignancy. Gut 1976;17:612-9.","journal-title":"Gut"},{"key":"ref_3","first-page":"301","article-title":"Malignant lymphoma in coeliac disease","volume-title":"Perspectives in coeliac disease","author":"Holmes, G.K.T.; Cooper, B.T.; Cooke, W.T.","year":"1978","unstructured":"Holmes GKT, Cooper BT, Cooke WT. Malignant lymphoma in coeliac disease. In: McNicholl B, McCarthy CF, Fottrell PF, eds. Perspectives in coeliac disease. Lancaster: MTP Press, 1978:301-8."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1136\/jcp.27.10.817","article-title":"The small intestine in dermatitis herpetiformis","volume":"27","author":"Fry, L.; Seah, P.P.; Harper, P.G.; Hoffbrand, A.V.; McMinn, R.M.H.","year":"1974","unstructured":"Fry L, Seah PP, Harper PG, Hoffbrand AV, McMinn RMH. The small intestine in dermatitis herpetiformis. J Clini Pathol 1974;27:817-24.","journal-title":"J Clini Pathol"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"857","DOI":"10.7326\/0003-4819-93-6-857","article-title":"Dermatitis herpetiformis-the skin and the gut","volume":"93","author":"Katz, S.I.","year":"1980","unstructured":"Katz SI. Dermatitis herpetiformis-the skin and the gut. Ann Inltern Med 1980;93:857-74.","journal-title":"Ann Inltern Med"},{"key":"ref_6","first-page":"410","article-title":"Coeliac disease. Proceedings of the second international coeliac symposium","volume":"1974","author":"In, Marks J.M.","unstructured":"Marks JM. In: Hekkens WTJM, Pena AS, eds. Coeliac disease. Proceedings of the second international coeliac symposium. Leiden: H E Stenfert Kroese BV, 1974:410.","journal-title":"Leiden: H E Stenfert Kroese BV"},{"key":"ref_7","first-page":"585","article-title":"Primary abdominal lymphoma-presenting manifestation of celiac sprue or complicating dermatitis herpetiformis","volume":"63","author":"Freeman, H.J.; Weinstein, W.M.; Shnitka, T.K.; Piercey, J.R.A.; Wensel, R.H.","year":"1977","unstructured":"Freeman HJ, Weinstein WM, Shnitka TK, Piercey JRA, Wensel RH. Primary abdominal lymphoma-presenting manifestation of celiac sprue or complicating dermatitis herpetiformis. Anm J Med 1977;63: 585-95.","journal-title":"Anm J Med"},{"key":"ref_8","first-page":"107","article-title":"Adult coeliac disease. A case with ulceration, dermatitis herpetiformis and reticulosarcoma","volume":"11","author":"Tonder, M.; Sorlie, D.; Kearney, M.S.","year":"1976","unstructured":"Tonder M, Sorlie D, Kearney MS. Adult coeliac disease. A case with ulceration, dermatitis herpetiformis and reticulosarcoma. Scand 7 Gastroenterol 1976;11:107."},{"key":"ref_9","first-page":"301","article-title":"Population and Census Surveys. Report of the advisory commlittee on cancer registration, 1980","volume":"107","author":"Oxford:","year":"1981","unstructured":"Office of Population and Census Surveys. Report of the advisory commlittee on cancer registration, 1980. London: HMSO, 1981. '0 Armitage P. Statistical mtethods in medical research. Oxford: Blackwell Scientific, 1971:426. \" Leonard JN, Haffenden GP, Ring N, et al. Adult linear IgA disease. BrJ Dermiatol 1982;107:301-16.","journal-title":"Leonard JN, Haffenden GP, Ring N, et al. Adult linear IgA disease. BrJ Dermiatol; 0 Armitage P. Statistical mtethods in medical research"},{"key":"ref_10","first-page":"819","article-title":"Malignant histiocytosis of the small intestine; its relationship to malabsorption and ulcerative jejunitis. Hum Pathol 1978; 9: 661-7. ' Weinstein WM","volume-title":"Latent coeliac sprue [Abstract.] Gastroenterology 1973; 64","author":"Isaacson, P.; Wright, D.H.","unstructured":"Isaacson P, Wright DH. Malignant histiocytosis of the small intestine; its relationship to malabsorption and ulcerative jejunitis. Hum Pathol 1978;9:661-7. ' Weinstein WM. Latent coeliac sprue [Abstract.] Gastroenterology 1973; 64:819."},{"key":"ref_11","first-page":"288","article-title":"Clearance of skin lesions in dermatitis herpetiformis after gluten withdrawal","volume":"i:","author":"Fry, L.; Seah, P.P.; Riches, D.J.; Hoffbrand, A.V.","year":"1973","unstructured":"Fry L, Seah PP, Riches DJ, Hoffbrand AV. Clearance of skin lesions in dermatitis herpetiformis after gluten withdrawal. 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