RESUMO
BACKGROUND: Dermatitis herpetiformis (DH) is a cutaneous manifestation of celiac disease. Both conditions are treated with a restrictive life-long gluten-free diet (GFD). Treated celiac disease patients have been shown to have more severe gastrointestinal symptoms and inferior quality of life compared with healthy controls, but evidence regarding quality of life in DH is lacking. OBJECTIVE: The aim was to evaluate whether long-term GFD-treated DH patients suffer from persistent gastrointestinal symptoms and if they experience a drawdown in quality of life. METHODS: Gastrointestinal symptoms and quality of life were assessed in 78 long-term GFD-treated DH patients using the validated Gastrointestinal Symptom Rating Scale, Psychological General Well-Being and Short Form 36 Health Survey questionnaires. The findings were compared with 110 healthy controls, population-based reference values and 371 treated celiac disease controls. RESULTS: The median age of the DH patients at the time of the study was 57 years, and 51 % were male. Significant differences in gastrointestinal symptoms or quality of life were not detected when treated DH patients were compared with healthy controls, but treated DH patients had less severe gastrointestinal symptoms and increased quality of life compared with celiac disease controls. Female DH patients had more severe gastrointestinal symptoms and reduced vitality compared with male DH patients. The presence of skin symptoms and the adherence to or duration of GFD did not have any influence on gastrointestinal symptoms or quality of life. CONCLUSION: We conclude that long-term GFD-treated DH patients do not suffer from the burden of dietary treatment and have a quality of life comparable to that of controls.
Assuntos
Doença Celíaca/dietoterapia , Doença Celíaca/epidemiologia , Dermatite Herpetiforme/dietoterapia , Dermatite Herpetiforme/epidemiologia , Dieta Livre de Glúten , Qualidade de Vida , Adolescente , Adulto , Fatores Etários , Idoso , Doença Celíaca/fisiopatologia , Comorbidade , Estudos Transversais , Dermatite Herpetiforme/diagnóstico , Dermatite Herpetiforme/psicologia , Diagnóstico Precoce , Feminino , Finlândia , Humanos , Assistência de Longa Duração , Masculino , Pessoa de Meia-Idade , Valores de Referência , Medição de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Resultado do Tratamento , Adulto JovemRESUMO
Impetigo Herpetiformis is a rare pustular dermatosis that typically occurs in pregnant women with unknown etiology. A 17 year old patient who developed Impetigo Herpetiformis for the second time in the 27th week of her 2nd pregnancy is presented. The patient improved with corticosteroids treatment but the lesions did not clear completely and had flare ups during stressful periods which brings us to conclusion that Impetigo Herpetiformis at least has a common pathway with Generalized Pustular Psoriasis in the pathogenesis as stress provoked exacerbations.
