Dermatitis Herpetiformis Cured by Hormone Replacement for Panhypopituitarism.

Spitzweg, Christine; Hofbauer, Lorenz C.; Heufelder, Armin E.

doi:10.1507/endocrj.44.437

Cited by 7 publications

(3 citation statements)

References 13 publications

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“…In dermatitis herpetiformis, one similar treatment failure has been described in a 53-year-old male. However, this patient differed from ours in that he had a giant pituitary adenoma; the skin disorder disappeared only after successful removal of the tumour (6).…”

Section: Discussioncontrasting

confidence: 79%

Autoimmune Hypopituitarism in Patients with Coeliac Disease: Symptoms Confusingly Similar

Collin¹,

Hakanen²,

Salmi³

et al. 2001

Scandinavian Journal of Gastroenterology

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Coeliac disease does not always respond properly to a gluten-free diet, and treatment may be complicated by an underlying autoimmune endocrine disorder. We report three cases of hypopituitarism in patients with coeliac disease who seemed to have incomplete dietary response. The first patient had diabetes and suffered from hypoglygaemic events; the second had muscular atrophy of unknown origin while the third had growth failure. None had a pituitary mass, suggesting that hypopituitarism was of autoimmune origin. Overall condition improved only after replacement therapy for the underlying hormone deficiency; this association should thus be recognized.

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Section: Discussioncontrasting

confidence: 79%

Autoimmune Hypopituitarism in Patients with Coeliac Disease: Symptoms Confusingly Similar

Collin¹,

Hakanen²,

Salmi³

et al. 2001

Scandinavian Journal of Gastroenterology

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“…Hormonal factors, and specifically the hypothalamic-pituitary-gonadal axis, may play a role in DH. Accordingly, hormone replacement therapy for panhypopituitarism has been reported to cure DH (86). One study reported DH following progesterone contraception (87).…”

Section: Pathogenesismentioning

confidence: 99%

Dermatitis Herpetiformis: Novel Perspectives

et al. 2019

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Dermatitis herpetiformis (DH) is an inflammatory disease of the skin, considered the specific cutaneous manifestation of celiac disease (CD). Both DH and CD occur in gluten-sensitive individuals, share the same Human Leukocyte Antigen (HLA) haplotypes (DQ2 and DQ8), and improve following the administration of a gluten-free diet. Moreover, almost all DH patients show typical CD alterations at the small bowel biopsy, ranging from villous atrophy to augmented presence of intraepithelial lymphocytes, as well as the generation of circulating autoantibodies against tissue transglutaminase (tTG). Clinically, DH presents with polymorphic lesions, including papules, vesicles, and small blisters, symmetrically distributed in typical anatomical sites including the extensor aspects of the limbs, the elbows, the sacral regions, and the buttocks. Intense pruritus is almost the rule. However, many atypical presentations of DH have also been reported. Moreover, recent evidence suggested that DH is changing. Firstly, some studies reported a reduced incidence of DH, probably due to early recognition of CD, so that there is not enough time for DH to develop. Moreover, data from Japanese literature highlighted the absence of intestinal involvement as well as of the typical serological markers of CD (i.e., anti-tTG antibodies) in Japanese patients with DH. Similar cases may also occur in Caucasian patients, complicating DH diagnosis. The latter relies on the combination of clinical, histopathologic, and immunopathologic findings. Detecting granular IgA deposits at the dermal-epidermal junction by direct immunofluorescence (DIF) from perilesional skin represents the most specific diagnostic tool. Further, assessing serum titers of autoantibodies against epidermal transglutaminase (eTG), the supposed autoantigen of DH, may also serve as a clue for the diagnosis. However, a study from our group has recently demonstrated that granular IgA deposits may also occur in celiac patients with non-DH inflammatory skin diseases, raising questions about the effective role of eTG IgA autoantibodies in DH and suggesting the need of revising diagnostic criteria, conceivably emphasizing clinical aspects of the disease along with DIF. DH usually responds to the gluten-free diet. Topical clobetasol ointment or dapsone may be also applied to favor rapid disease control. Our review will focus on novel pathogenic insights, controversies, and management aspects of DH.

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“…Definida como dermatose bolhosa autoimune crônica, a DH tem patogênese multifatorial, dependendo de componentes genéticos, ambiental e imunológico 9 . A influência de fatores hormonais na patogenia da doença é descrita na literatura, sendo considerada gatilho para a DH, podendo deflagrar ou mesmo exacerbar um quadro clínico [4][5][6][7]10 . No caso apresentado, foi relatada associação da piora clínica, através do surgimento de novas lesões cutâneas, no período menstrual, a cada novo ciclo, com a interrupção do uso de anovulatório oral.…”

Section: Discussionunclassified

Dermatite Herpetiforme Com Exacerbação Clínica Após Interrupção Do Uso De Anovulatório Oral

Castro

Cunha

Lima

et al. 2014

SPDV

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Dermatite herpetiforme é uma dermatose autoimune caracterizada por lesões papulo vesiculosas pruriginosas e simétricas, que ocorrem com disposição herpetiforme. A doença tem patogênese multifatorial, dependendo de componentes genéticos, ambiental e imunológico. Há evidências que sugerem que fatores hormonais podem desempenhar um papel na doença. Os autores descrevem o caso de uma paciente do sexo feminino, 28 anos, com dermatite herpetiforme e enteropatia glúten sensível, cujas lesões cutâneas exacerbadas mensalmente durante o período menstrual, após interrupção do uso de anovulatório oral.

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Dermatitis Herpetiformis Cured by Hormone Replacement for Panhypopituitarism.

Cited by 7 publications

References 13 publications

Autoimmune Hypopituitarism in Patients with Coeliac Disease: Symptoms Confusingly Similar

Autoimmune Hypopituitarism in Patients with Coeliac Disease: Symptoms Confusingly Similar

Dermatitis Herpetiformis: Novel Perspectives

Dermatite Herpetiforme Com Exacerbação Clínica Após Interrupção Do Uso De Anovulatório Oral

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