{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T23:38:27Z","timestamp":1787701107491,"version":"build-2784847793"},"reference-count":43,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T00:00:00Z","timestamp":1704931200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI18\/00989"],"award-info":[{"award-number":["PI18\/00989"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Dermatitis herpetiformis is a cutaneous manifestation of celiac disease. Phenotyping of intraepithelial lymphocytes in the small bowel mucosa can strengthen the diagnosis of celiac disease when it is not clear-cut. We aim to evaluate the usefulness of the intraepithelial lymphogram to confirm dermatitis herpetiformis in equivocal cases. We performed a retrospective multicenter study on patients diagnosed with dermatitis herpetiformis and collected data from the intraepithelial lymphogram assessed by flow cytometry. A total of 36 patients were analyzed in relation to the severity of intestinal damage (18 had non-atrophic mucosa) at baseline (N = 28) and\/or after the adoption of a gluten-free diet (median follow-up of three years, N = 16). We observed that patients with atrophy more often had positive celiac serology (p = 0.019), celiac clinical symptoms (p = 0.018), and iron-deficiency anemia (p = 0.018), but the severity of skin damage was similar in both groups (p = 0.79). At baseline, increased TCR\u03b3\u03b4+ cells were present in 94% of patients with atrophy and 67% with non-atrophic lesions (p = 0.13). After a gluten-free diet, increased TCR\u03b3\u03b4+ cells persisted in 100% and 63% of cases, respectively (p = 0.21). We concluded that increased TCR\u03b3\u03b4+ cells may be helpful in confirming the diagnosis of dermatitis herpetiformis in equivocal cases, even in patients who were started on a gluten-free diet.<\/jats:p>","DOI":"10.3390\/nu16020232","type":"journal-article","created":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T03:21:41Z","timestamp":1704943301000},"page":"232","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Improving the Diagnosis of Dermatitis Herpetiformis Using the Intraepithelial Lymphogram"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1489-504X","authenticated-orcid":false,"given":"Fernando","family":"Fern\u00e1ndez-Ba\u00f1ares","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Hospital Universitari Mutua Terrassa, 08221 Terrasa, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Crespo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital Universitario Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"Planella","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital Arnau Vilanova, 25198 Lleida, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Farrais","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Izquierdo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital Cl\u00ednico Universitario, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"L\u00f3pez-Palacios","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria Hospital Cl\u00ednico San Carlos, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6124-7574","authenticated-orcid":false,"given":"Garbi\u00f1e","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Immunology, Hospital Universitario Ram\u00f3n y Cajal, Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Vidal","sequence":"additional","affiliation":[{"name":"Section of Flow Cytometry, CATLAB, 08232 Viladecavalls, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9489-1603","authenticated-orcid":false,"given":"Concepci\u00f3n","family":"N\u00fa\u00f1ez","sequence":"additional","affiliation":[{"name":"Laboratorio de Investigaci\u00f3n en Gen\u00e9tica de Enfermedades Complejas, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria Hospital Cl\u00ednico San Carlos, 28040 Madrid, Spain"},{"name":"Redes de Investigaci\u00f3n Cooperativa Orientada a Resultados en Salud (RICORS), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1080\/07853890.2016.1222450","article-title":"Dermatitis herpetiformis: A cutaneous manifestation of coeliac disease","volume":"49","author":"Collin","year":"2017","journal-title":"Ann. 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