Frödin T, Gotthard R, Hed J, Molin L, Norrby K, Walan A
Acta Derm Venereol. 1981;61(5):405-11.
In 32 patients with dermatitis herpetiformis (DH) we studied the effect of gluten-free (22 patients) and gluten-reduced (10 patients) diet for periods ranging between 15 and 43 months. Variables such as cutaneous manifestations, dependence on dapsone, IgA deposits in the skin, small-bowel function, and jejunal mucosal morphology were studied. 59% of the patients on gluten-free diet could stop dapsone medication and remain symptom-free, compared with 10% on gluten-reduced diet. The time needed to achieve this therapeutic response varied from 5 to 31 months. IgA decreased in the skin to a degree which roughly paralleled the morphological normalization of the jejunal mucosa. In no patient, however, did the IgA completely disappear. It is suggested that IgA is not the main factor inducing DH symptoms, but rather a secondary phenomenon. Repeated jejunal biopsies revealed normalization of the mucosal histology in 52% of the patients on gluten-free diet, compared with none in the gluten-reduced diet group.
在32例疱疹样皮炎（DH）患者中，我们研究了无麸质饮食（22例患者）和低麸质饮食（10例患者）在15至43个月期间的效果。研究了皮肤表现、对氨苯砜的依赖性、皮肤中的IgA沉积、小肠功能和空肠黏膜形态等变量。59%的接受无麸质饮食的患者可以停用氨苯砜药物且保持无症状，而接受低麸质饮食的患者这一比例为10%。达到这种治疗反应所需的时间为5至31个月。皮肤中的IgA下降程度大致与空肠黏膜的形态正常化平行。然而，没有患者的IgA完全消失。提示IgA不是诱发DH症状的主要因素，而是一种继发现象。反复的空肠活检显示，52%接受无麸质饮食的患者黏膜组织学正常化，而低麸质饮食组无一例正常。
