Two-thirds of patients with dermatitis herpetiformis have been found to have a flat or convoluted mucosa but no special association has been found in the other dermatoses studied with structural alterations in the small bowel mucosa. The frequency distribution of the predominant and individual small intestinal mucosal features is the same in the patients in the present series with eczema, psoriasis, and rosacea as in the local control population. A predominantly convoluted mucosa has been found in the upper small intestine in 8% of these patients and in 8% of subjects without a rash. The presence of convolutions in patients with these dermatoses is merely a reflection of the incidence in the normal population of Newcastle upon Tyne. Different findings in the same skin disease in different parts of the country are explicable on the basis of variations in the normal mucosa between one geographical region and another. The increased incidence of a convoluted mucosa in the north east of England requires further study to determine whether it is indicative of an increased incidence of the coeliac syndrome in the region, or whether it results from a minor population difference or a local peculiarity of diet.

Adult↗

PubMed1970

Dermatogenic enteropathy.

Steatorrhoea has been found in a large proportion of patients with inflammatory dermatoses, especially eczema and psoriasis. It is due to the rash itself and disappears rapidly after topical treatment of the skin. This particular enteropathy, unlike that associated with dermatitis herpetiformis, is not accompanied by an alteration in the stereomicroscopic appearance of the small bowel mucosa. The mechanism is not known. It is important to differentiate dermatogenic enteropathy from gluten sensitivity which has produced a rash, as in the former condition a gluten-free diet is not indicated.

Biopsy↗

PubMed1970

Small intestinal mucosal abnormalities in relatives of patients with dermatitis herpetiformis.

Jejunal biopsy has been carried out in 19 relatives of patients with dermatitis herpetiformis and stereomicroscopic abnormalities have been found in seven. The majority of the relatives in whom these abnormalities were found had no bowel symptoms: one had the rash of dermatitis herpetiformis. All but one of the propositi of the relatives in whom were found small intestinal mucosal abnormalities themselves had the coeliac syndrome. It is concluded that a genetic factor is involved in the production of the enteropathy of dermatitis herpetiformis as in other forms of the coeliac syndrome.

Adolescent↗

PubMed1970