Cooper B T, Mallas E, Trotter M D, Cooke W T
Gut. 1978 Aug;19(8):754-8. doi: 10.1136/gut.19.8.754.
Twenty-one patients with dermatitis herpetiformis have been on a gluten free diet regularly followed up for at least one year (mean four years). Eighteen patients had a 'flat' mucosal appearance (grade III), one patient had moderately severe mucosal abnormality (grade II), one patient had mild mucosal abnormality (grade I), and one patient had a normal mucosal appearance (grade O). On the diet, 10 patients had no skin rash and took no dapsone, seven patients controlled the skin rash on a lower dose of dapsone, and four noticed no improvement. There was no correlation between pre-diet jejunal morphology and response of the skin. A repeat jejunal biopsy, on the gluten free diet, was possible in 15 patients. While all those with skin improvement showed some improvement in jejunal morphology, there was no association between the degree of skin improvement and the degree of recovery of the jejunal mucosa.
21例疱疹样皮炎患者长期坚持无麸质饮食，定期随访至少1年（平均4年）。18例患者黏膜外观“扁平”（Ⅲ级），1例患者有中度严重黏膜异常（Ⅱ级），1例患者有轻度黏膜异常（Ⅰ级），1例患者黏膜外观正常（0级）。在饮食期间，10例患者无皮疹且未服用氨苯砜，7例患者用较低剂量氨苯砜控制了皮疹，4例患者未见改善。饮食前空肠形态与皮肤反应之间无相关性。15例患者在无麸质饮食期间可行空肠重复活检。虽然所有皮肤改善的患者空肠形态均有一定改善，但皮肤改善程度与空肠黏膜恢复程度之间无关联。
