Premium
No increase in risk of fracture, malignancy or mortality in dermatitis herpetiformis: a cohort study
Author(s) -
LEWIS N. R.,
LOGAN R. F. A.,
HUBBARD R. B.,
WEST J.
Publication year - 2008
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2008.03660.x
Subject(s) - dermatitis herpetiformis , medicine , hazard ratio , malignancy , coeliac disease , population , standardized mortality ratio , cancer , dermatology , disease , gastroenterology , confidence interval , environmental health
Summary Background Dermatitis herpetiformis forms part of the same spectrum of gluten‐sensitive disorders as coeliac disease yet may have different risks of morbidity and mortality. Aims To quantify the risks of fracture, malignancy and mortality in people with dermatitis herpetiformis compared with the general population. Methods Using the General Practice Research Database, we identified 846 people with dermatitis herpetiformis and 4225 age‐, gender‐ and practice‐matched controls. We used Cox regression to estimate hazard ratios. Results Comparing people with dermatitis herpetiformis to the general population, the overall hazard ratio for any fracture was 1.1 (95% CI: 0.77–1.52). The overall hazard ratio for any malignancy was 1.0 (95% CI: 0.73–1.49); there was no increased risk of gastrointestinal (HR: 1.6; 95% CI: 0.67–3.67) or lymphoproliferative cancers (HR: 1.6; 95% CI: 0.44–6.06). A reduction in risk of breast cancer was not statistically significant (HR: 0.19; 95% CI: 0.03–1.39). The hazard ratio for all‐cause mortality was 0.93 (95% CI: 0.70–1.23). Conclusions Unlike the fivefold increase in risk seen in coeliac disease, we found no increased risk of lymphoproliferative cancer and no increase in fracture, malignancy or mortality in people with dermatitis herpetiformis compared with the general population. It is not clear whether differences in degree of intestinal inflammation or other reasons account for this. Like coeliac disease, dermatitis herpetiformis may protect against breast cancer.