ABSTRACT
Celiac disease (CD) is an immune-mediated, gluten-induced enteropathy that affects predisposed individuals of all ages. Many patients with CD do not report gastrointestinal symptoms making it difficult to reach an early diagnosis. On the other hand, CD is related to a wide spectrum of extra-intestinal manifestations, with dermatitis herpetiformis (DH) being the best characterized. These associated conditions may be the clue to reaching the diagnosis of CD. Over the last few years, there have been multiple reports of the association between CD and several cutaneous manifestations that may improve with a gluten-free diet (GFD). The presence of some of these skin diseases, even in the absence of gastrointestinal symptoms, should give rise to an appropriate screening method for CD. The aim of this paper is to describe the different cutaneous manifestations that have been associated with CD and the possible mechanisms involved.
Subject(s)
Celiac Disease/diagnosis , Mucous Membrane/pathology , Skin Diseases/diagnosis , Skin/pathology , Alopecia Areata/complications , Alopecia Areata/diagnosis , Celiac Disease/complications , Dermatitis Herpetiformis/complications , Dermatitis Herpetiformis/diagnosis , Dermatitis, Atopic/complications , Dermatitis, Atopic/diagnosis , Diet, Gluten-Free , Gastrointestinal Diseases/complications , Gastrointestinal Diseases/diagnosis , Glutens/administration & dosage , Humans , Psoriasis/complications , Psoriasis/diagnosis , Rosacea/complications , Rosacea/diagnosis , Skin Diseases/complications , Stomatitis, Aphthous/complications , Stomatitis, Aphthous/diagnosis , Urticaria/complications , Urticaria/diagnosis , Vasculitis, Leukocytoclastic, Cutaneous/complications , Vasculitis, Leukocytoclastic, Cutaneous/diagnosisABSTRACT
Allogeneic hematopoietic stem-cell transplantation and solid-organ transplantation are associated with an increased risk of secondary neoplasms. Indeterminate cell histiocytosis (ICH) is a rare disease composed of so-called indeterminate cells, an alleged cutaneous dendritic cell subset displaying histological and some ultrastructural and immunophenotypic features of Langerhans cells but lacking Birbeck granules. We report a case of cutaneous ICH occurring after allogeneic hematopoietic stem-cell transplantation for a myelodysplastic syndrome in a 56-year-old man. Microsatellite analysis demonstrated that the neoplastic cells were derived from the donor's hematopoietic system. This case broadens the spectrum of complications after stem-cell transplantation and demonstrates that cutaneous ICH in the setting of myelodysplastic syndromes may have a nonrelated origin to dysplastic myeloid cells.
