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Erythema elevatum diutinum in association with coetiac disease
Author(s) -
TASANEN K.,
RAUDASOJA R.,
KALLIOINEN M.,
RANKI A.
Publication year - 1997
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1046/j.1365-2133.1997.d01-1250.x
Subject(s) - dapsone , dermatitis herpetiformis , medicine , villous atrophy , erythema , skin biopsy , dermatology , biopsy , pathology , immunoglobulin a , coeliac disease , immunology , disease , antibody , gastroenterology , immunoglobulin g
Summary Erythema elevatum diutinum (EED) has been described in association with several immunological or infectious diseases. We describe a female patient who presented with clinically and histologically typical EED in whom previously undiagnosed coetiac disease was found. Appearance of EED lesions was preceded by widespread joint pains. In extensive laboratory tests, the only abnormal findings were an elevated erythrocyte sedimentation rate (ESR) and decreased haemoglobin and folic acid levels. Later. IgA and IgG type antireticulin and antigliadin antibodies were detected. Serum total IgA was elevated but no paraproteinaemia was found. In lesional skin, granular deposits of IgA and C3 were seen at the dermo‐epidermal junction. A duodenal biopsy revealed total villous atrophy. Dapsone treatment was partly effective but complete healing of the EED lesions was achieved only after the introduction of a strict gluten‐free diet. The patient has now remained symptom‐free on the diet for 1.5 years.