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[与皮肤结节病性肉芽肿相关的乳糜泻]

[Celiac disease associated with cutaneous sarcoidosic granuloma].

作者信息

Loche F, Bazex J

机构信息

Service de dermatologie-vénéréologie-allergologie, CHU Purpan, Toulouse, France.

出版信息

Rev Med Interne. 1997;18(12):975-8. doi: 10.1016/s0248-8663(97)80118-x.

Abstract

Coeliac disease can be associated with numerous internal, skin and mucosa involvements: their physiopathology is often obscure. We report the case of a 14-year old female patient who suffered from a coeliac disease diagnosed in 1988 with considerable improvement with a gluten-free diet. Her two daughters also presented coeliac disease and her sister suffered from nevoid basal cell carcinoma syndrome. Four years later, she presented non pruriginous small nodules over both lower extremities. Skin biopsy revealed a non-caseating granuloma into the derm: we only could evocate sarcoidosis affecting the skin. The dermatological lesions improved during the following weeks with a gluten free diet and relapsed each time this diet was stopped. Many clinical associations with coeliac disease have been described with numerous visceral and skin-mucosa involvements. Eight cases of coeliac disease associated with sarcoidosis affecting the lung have been reported: in five cases, coeliac disease preceded sarcoidosis and in one case sarcoidosis relapsed each time gluten was reintroduced like in our case. This two diseases seem to share immunological and genetic disturbances.

摘要

乳糜泻可伴有多种内脏、皮肤和黏膜受累情况:其病理生理学往往不明。我们报告一例14岁女性患者,1988年被诊断为乳糜泻,采用无麸质饮食后病情有显著改善。她的两个女儿也患有乳糜泻,她的姐姐患有痣样基底细胞癌综合征。四年后,她双下肢出现无瘙痒的小结节。皮肤活检显示真皮内有非干酪样肉芽肿:我们只能推测是结节病累及皮肤。接下来的几周里,无麸质饮食使皮肤病变有所改善,但每次停止这种饮食,病变就会复发。乳糜泻有许多临床关联情况,涉及多种内脏以及皮肤黏膜受累。已有8例乳糜泻合并结节病累及肺部的报道:其中5例乳糜泻先于结节病出现,1例结节病每次重新摄入麸质时就复发,如同我们的病例。这两种疾病似乎存在免疫和遗传紊乱。

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