Erythema Elevatum Diutinum Associated with Celiac Disease: Response to a Gluten‐Free Diet

Rodríguez‐Serna, Mercedes; Fortea, Jose-Miguel; Pérez, Amparo Sancho; Febrer, I.; Ribes, Carmen; Aliaga, Adolfo

doi:10.1111/j.1525-1470.1993.tb00036.x

Cited by 35 publications

(27 citation statements)

References 20 publications

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“…Langerhans' cells have also been postulated in the pathogenesis of EED, suggesting that cell‐mediated reactions may play a role . The formation of granulomas advocate T‐cell‐mediated delayed hypersensitivity reactions …”

Section: Dermatopathology and Pathogenesismentioning

confidence: 91%

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Erythema elevatum diutinum: a review of presentation and treatment

Momen

Jorizzo

Al‐Niaimi

2014

Acad Dermatol Venereol

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Erythema elevatum diutinum (EED) is a rare, chronic and treatable skin condition. It has many histological mimics and is often associated with a variety of underlying systemic diseases, when these are present the management and prognosis dictates the course of the EED. This review aims to highlight the differential diagnosis, clinical manifestations of EED and the possible underlying systemic disease. It is important for clinicians to be aware that EED may predate underlying conditions and the presence of lesions may indicate underlying disease activity. In some cases one may need 'search' for underlying disease. Treatment of these lesions is notoriously difficult. Dapsone is used as the mainstay of treatment, however other options exist. We have highlighted different treatment options and suggested a treatment algorithm. In some cases, treatment may need to be targeted at underlying disease.

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Section: Dermatopathology and Pathogenesismentioning

confidence: 91%

“…Where the CD4 count was stated, eight (42%) patients had a CD4 count of less than 200. Seven of the patients described presented with nodular EED . The stimulus for EED could be due to immune‐complex deposition in blood vessels triggered by the HIV infection itself, or other infections acting as antigenic stimuli .…”

Section: Eed and Associationsmentioning

confidence: 99%

Erythema elevatum diutinum: a review of presentation and treatment

Momen

Jorizzo

Al‐Niaimi

2014

Acad Dermatol Venereol

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“…Hernandez-Cano et al reported the disappearance of EED lesions in a patient with a liver transplantation following a reduction in cyclosporin dosage [12]. However, EED lesions may not respond to dapsone, or if they do, recurrences are quite common [5,11,24,31,39]. It is possible that the marked fibrosis in late lesions may account for the lack of response to dapsone [8].…”

Section: Discussionmentioning

confidence: 90%

“…Other modes of therapy with variable response include clofazimine, chloroquine, niacinamide, tetracycline, steroids, topical betamethazone, flucinolone under occlusion, phenformin, Colchicine and salfapyridine [10,11,13,19,23,34,37,41]. In one case of EED associated with celiac disease, while dapsone did not improve the skin manifestations, the lesions disappeared with a gluten-free diet [31]. In patients with EED associated with HIV infection, adequate antiretroviral therapy in addition to conventional dapsone therapy was used successfully [38].…”

Section: Discussionmentioning

confidence: 94%

Erythema elevatum diutinum and plastic surgery Case report

Lari¹,

George

Al-Saeed

2002

European Journal of Plastic Surgery

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Erythema elevatum diutinum (EED) is a chronic form of leucocytoclastic vasculitis that presents with symmetrical plaques, papules, and nodules in an acral distribution. The treatment is conservative, with dapsone being the first choice among the drugs commonly used. However, the late lesions may not respond due to the marked fibrosis, and they are extremely stressful to the patient both symptomatically and cosmetically. A case of EED in a patient with history of splenectomy for idiopathic thrombocytopenic purpura (ITP) is presented, where the late cutaneous lesions were excised and skin grafted. The association with splenectomy and the use of skin grafting as a mode of treatment when all other modalities have failed, have not been reported previously. A review of the relevant literature is presented.

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“…Behçet's disease is also associated with neutrophil-rich infiltrates of the skin. Aside from IgA paraproteinemia with or without myeloma, myelodysplastic and myeloproliferative diseases, lymphoma and POEMS syndrome, EED is associated with arthralgia and a number of autoimmune and inflammatory disorders such as rheumatoid arthritis [1], ulcerative colitis [2], Crohn's disease [3], relapsing polychondritis [4], type 1 diabetes [5], Wegener's granulomatosis [6], celiac disease [7], myasthenia gravis [8], hyper-IgD syndrome [9] and HIV infection [10]. We found no association of multiple sclerosis with EED.…”

mentioning

confidence: 99%