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24-03-2011 | Article

Dermatitis herpetiformis can go into remission

Abstract

Free abstract

MedWire News: Patients with the chronic skin condition dermatitis herpetiformis can experience remission of their symptoms, say researchers.

They advise doctors to continually re-evaluate their patients need for therapy and a gluten-free diet if their symptoms are well-controlled, to see if they might actually be in remission.

Dermatitis herpetiformis is a blistering skin disease associated with celiac disease and is considered to be a long-term condition.

Stephen Katz and colleagues from the National Institutes of Health in Bethesda, Maryland, investigated the long-term prognosis of the condition in 86 patients who had suffered from the skin disease for at least 2 years and were monitored, or followed-up, for at least 3 years.

Patients were considered to be in remission if they had no skin lesions or symptoms of dermatitis herpetiformis for more than 2 years while not receiving treatment or adhering to a gluten-free diet.

"Over the years of follow-up, all patients were asked to taper their sulfone or sulfapyridine medication to be certain that they were taking the lowest dose possible to control their disease," the researchers explain in the Archives of Dermatology.

"This is, in part, how we learned that some patients no longer required therapy."

In all, 12% of the patients underwent remission. The likelihood of remission increased with longer disease duration and was more common in patients who developed the condition at an older age (39 years and older vs ages 8 to 38 years).

"The results of this study emphasize the importance of reducing sulfone or sulfapyridine therapy and attempting to wean patients with well-controlled dermatitis herpetiformis from a gluten-free diet," say Katz and colleagues.

"However, before changing their diets, patients with symptomatic celiac disease should discuss options with the physician managing their gastrointestinal tract condition."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011