Journal of Clinical & Experimental Dermatology Research
Open Access
ISSN: 2155-9554
ISSN: 2155-9554
Michael J Lentze
Universit�?¤tsklinikum Bonn, Germany
Tbilisi State Medical University, Georgia
Posters & Accepted Abstracts: J Clin Exp Dermatol Res
In coeliac disease gluten triggers an autoimmune reaction, which affects not only the gastrointestinal tract with inflammation, malabsorption and villous atrophy but can also be associated with other autoimmune diseases as diabetes mellitus I, thyroid disease and skin disease like dermatitis herpetiformis, linear IgA bullous dermatosis, urticaria, psoriasis and vitiligo. However there is an ongoing controversial discussion, whether vitiligo is related to coeliac disease. The prevalence of vitiligo in the general population is reported to be 0.5-2%. In cohorts of celiac patients higher prevalence of 3.8-9.1% were observed. In studies of vitiligo patients for autoimmune antibodies for celiac disease, the results are conflicting. In some studies a statistical correlation was found, in others no correlation could be determined. A convincing argument for a relation between vitiligo and coeliac disease would be the amelioration of vitiligo in patients with coeliac disease after introduction of a gluten free diet. The largest study for the amelioration of symptoms in coeliac patients after introduction of gluten free diet was performed by Norstrom et al in Sweden. Here in 1031 adult patients with coeliac disease of different ages the results of a gluten free diet on a wide range of symptoms was assessed. Among these patients 3.8% (n=39) had vitiligo. After introduction of a gluten free diet, 34 patients showed an amelioration of vitiligo (p<0.01). In children with coeliac disease vitiligo was reported at a prevalence of 2% similar to the general population. In one child with coeliac disease re-pigmentation of vitiligo was reported after the introduction of gluten free diet. Vitiligo and coeliac disease can occur together. Adult patients with coeliac disease and vitiligo can benefit from a gluten free diet. In children with coeliac disease and vitiligo only singular reports are exist for the improvement of skin re-pigmentation after a gluten free diet. The large Swedish study by Norstrom et al., suggests a relationship between the two diseases. Therefore patients with vitiligo should be screened for transglutaminase IgA antibodies including the determination of total serum IgA in order to assess underlying coeliac disease.