{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T19:01:35Z","timestamp":1766516495259,"version":"3.46.0"},"reference-count":33,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1984,2]]},"abstract":"<jats:p>We describe a long term study of 76 patients with dermatitis herpetiformis. Unlike patients with coeliac disease, where the peak incidence was during the first and fourth decades, no dermatitis herpetiformis patients presented in the first decade; also, there was a male preponderance in dermatitis herpetiformis which contrasts with the excess of females in coeliac disease. The apparent prevalence of dermatitis herpetiformis was 11 per 100 000 in our population; approximately one fifth of that of coeliac disease. Jejunal villous atrophy was present in 78% of our dermatitis herpetiformis patients, and a single jejunal biopsy was as effective at detecting this as the multiple biopsy technique. A majority of patients were able to stop, or radically reduce their dapsone or sulphapyridine treatment after the institution of a gluten free diet. Spontaneous remission of the skin lesion occurred in only two patients not receiving a gluten free diet. Gastric parietal or thyroid antibodies were detected in 38% of patients, and three cases of thyroid disease and two cases of pernicious anaemia were detected. Lymphoma developed in two patients, one being intestinal in origin. We conclude that a gluten free diet is of therapeutic benefit in dermatitis herpetiformis and that spontaneous remission is uncommon in those not on a diet. Despite patchiness of the enteropathy, a single jejunal biopsy is quite adequate to diagnose the presence of upper intestinal villous atrophy.<\/jats:p>","DOI":"10.1136\/gut.25.2.151","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"151-157","source":"Crossref","is-referenced-by-count":107,"title":["Dermatitis herpetiformis: diagnosis, diet and demography."],"prefix":"10.1136","volume":"25","author":[{"given":"D J","family":"Gawkrodger","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J N","family":"Blackwell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H M","family":"Gilmour","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E A","family":"Rifkind","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R C","family":"Heading","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R S","family":"Barnetson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1984,2,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1016\/S0140-6736(66)91692-8","article-title":"Small bowel changes in dermatitis herpetiformis","volume":"2","author":"Marks, J.; Shuster, S.; Watson, A.J.","year":"1966","unstructured":"Marks J, Shuster S, Watson AJ. Small bowel changes in dermatitis herpetiformis. Lancet 1966; 2: 1280-2.","journal-title":"Lancet"},{"issue":"100","key":"ref_2","first-page":"129","article-title":"Gluten free diet and reintroduction of gluten in dermatitis herpetiformis","volume":"1969","author":"Fry, L.; McMinn, R.M.H.; Cowan, J.D.; Hoffbrand, A.V.","unstructured":"Fry L, McMinn RMH, Cowan JD, Hoffbrand AV. Gluten free diet and reintroduction of gluten in dermatitis herpetiformis. Arch Dermatol 1969; 100: 129-35.","journal-title":"Arch Dermatol"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/S0016-5085(71)80115-4","article-title":"The small intestinal mucosa in dermatitis herpetiformis II. Relationship of the small intestinal lesion to gluten","volume":"60","author":"Weinstein, W.M.; Brow, JR, Parker; F, Rubin; C.E.","year":"1971","unstructured":"Weinstein WM, Brow JR, Parker F, Rubin CE. The small intestinal mucosa in dermatitis herpetiformis II. Relationship of the small intestinal lesion to gluten. Gastroenterology 1971; 60: 362-9.","journal-title":"Gastroenterology"},{"key":"ref_4","first-page":"2977","article-title":"HL-A8: a genetic link between dermatitis herpetiformis and gluten sensitive enteropathy","volume":"52","author":"Katz, S.I.; Falchuk, Z.M.; Dahl, M.V.; Rogentine, G.N.; Strober, W.","year":"1972","unstructured":"Katz SI, Falchuk ZM, Dahl MV, Rogentine GN, Strober W. HL-A8: a genetic link between dermatitis herpetiformis and gluten sensitive enteropathy. J Clin Invest 1972; 52: 2977-80.","journal-title":"J Clin Invest"},{"key":"ref_5","first-page":"133","article-title":"The incidence of HL-A antigens in dermatitis herpetiformis","volume":"89","author":"White, A.G.; RStC, Barnetson; Da Costa, J.A.G.; McClelland, D.B.L.","year":"1973","unstructured":"White AG, Barnetson RStC, Da Costa JAG, McClelland DBL. The incidence of HL-A antigens in dermatitis herpetiformis. 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Am J Dig Dis 1974; 19: 704-8.","journal-title":"Am J Dig Dis"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1111\/j.1365-2133.1974.tb06377.x","article-title":"Dermatitis herpetiformis: an evaluation of diagnostic criteria","volume":"90","author":"Fry, L.; Seah, P.P.","year":"1974","unstructured":"Fry L, Seah PP. Dermatitis herpetiformis: an evaluation of diagnostic criteria. Br J Dermatol 1974; 90: 137-46.","journal-title":"Br J Dermatol"},{"key":"ref_26","first-page":"754","article-title":"Response of the skin in dermatitis herpetiformis to a gluten free diet with reference to jejunal morphology","volume-title":"Gut","volume":"19","author":"Cooper, B.T.; Mallas, E.; Trotter, M.D.; Cooke, W.T.","year":"1978","unstructured":"Cooper BT, Mallas E, Trotter MD, Cooke WT. Response of the skin in dermatitis herpetiformis to a gluten free diet with reference to jejunal morphology. Gut 1978; 19: 754-8."},{"key":"ref_27","first-page":"66","article-title":"Coeliac disease","volume-title":"Immunology of the gastrointestinal tract","author":"Asquith, P.; Haeney, M.R.","year":"1979","unstructured":"Asquith P, Haeney MR. Coeliac disease. In: Asquith P ed. Immunology of the gastrointestinal tract. Edinburgh: Churchill Livingstone, 1979: 66-94."},{"issue":"64","key":"ref_28","first-page":"1","article-title":"Prognosis of dermatitis herpetiformis treated and untreated","volume":"1957","author":"Eyster, W.H.; Kierland, R.R.","unstructured":"Eyster WH, Kierland RR. Prognosis of dermatitis herpetiformis treated and untreated. Arch Dermatol 1957: 64: 1-8.","journal-title":"Arch Dermatol"},{"key":"ref_29","article-title":"Dermatitis herpetiformis","author":"JO'D, Alexander","year":"1975","unstructured":"Alexander JO'D. Dermatitis herpetiformis. London: WB Saunders, 1975; 30."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1136\/bmj.286.6359.95","article-title":"Changes in the clinical features of adult coeliac disease in Edinburgh and the Lothians 19661979","volume":"286","author":"Logan, R.F.A.; Tucker, G.; Rifkind, E.A.; Heading, R.C.; Ferguson, A.","year":"1983","unstructured":"Logan RFA, Tucker G, Rifkind EA, Heading RC, Ferguson A. Changes in the clinical features of adult coeliac disease in Edinburgh and the Lothians 19661979. Br Med J 1983; 286: 95-7.","journal-title":"Br Med J"},{"key":"ref_31","first-page":"478","article-title":"IgA in dermatitis herpetiformis is dimeric Lancet","volume":"1","author":"Unsworth, D.J.; Payne, A.W.; Leonard, J.N.; Fry, L.; Holborow, E.J.","year":"1982","unstructured":"Unsworth DJ, Payne AW, Leonard JN, Fry L, Holborow EJ. IgA in dermatitis herpetiformis is dimeric Lancet 1982; 1: 478-80."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1111\/1523-1747.ep12507494","article-title":"Provost 1T. Induction of IgA circulating immune complexes after wheat feeding in dermatitis herpetiformis patients","volume":"78","author":"Zone, J.J.; La Salle, B.A.","year":"1982","unstructured":"Zone JJ, La Salle BA, Provost 1T. Induction of IgA circulating immune complexes after wheat feeding in dermatitis herpetiformis patients. J Invest Dermatol 1982; 78: 375-80.","journal-title":"J Invest Dermatol"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/j.1365-2133.1978.tb01957.x","article-title":"IgA and C3 complement in the uninvolved skin in dermatitis herpetiformis after gluten withdrawal","volume":"99","author":"Fry, L.; Haffenden, G.; Wojnarowska, F.T.; Thompson, B.R.; Seah, P.P.","year":"1978","unstructured":"Fry L, Haffenden G, Wojnarowska FT, Thompson BR, Seah PP. IgA and C3 complement in the uninvolved skin in dermatitis herpetiformis after gluten withdrawal. Br J Dermatol 1978; 99: 31-7.","journal-title":"Br J Dermatol"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.25.2.151","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T03:46:21Z","timestamp":1764992781000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.25.2.151"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1984,2]]},"references-count":33,"journal-issue":{"issue":"2","published-online":{"date-parts":[[1984,2,1]]},"published-print":{"date-parts":[[1984,2]]}},"alternative-id":["10.1136\/gut.25.2.151"],"URL":"https:\/\/doi.org\/10.1136\/gut.25.2.151","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"type":"print","value":"0017-5749"},{"type":"electronic","value":"1468-3288"}],"subject":[],"published":{"date-parts":[[1984,2]]}}}