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Ichthyosis revealing coeliac disease
S Menni1, D Boccardi, A Brusasco
1IV Department of Dermatology, Pediatric Dermatology, University of Milan, Ospedale S. Paolo, Via A. di Rudinì 8, 20142 Milano, Italy.
European Journal of Dermatology : EJD
|July 7, 2000
Summary
A woman with acquired ichthyosis and high parathormone levels was diagnosed with celiac disease. A gluten-free diet significantly improved her skin condition and bone density.
Area of Science:
- Dermatology
- Gastroenterology
- Endocrinology
Background:
- Celiac disease is an autoimmune disorder triggered by gluten ingestion, primarily affecting the small intestine.
- Cutaneous manifestations of celiac disease are diverse and can include dermatitis herpetiformis, but acquired ichthyosis is a rare presentation.
- Secondary hyperparathyroidism can occur in celiac disease due to malabsorption of calcium and vitamin D.
Observation:
- A 29-year-old woman presented with lamellar desquamation on her abdomen, submammary folds, and limbs, mimicking acquired ichthyosis.
- Laboratory tests revealed elevated parathormone and antiendomysial antibodies, with reduced bone mineral density.
- Duodenal biopsy confirmed total villous atrophy, indicative of celiac disease.
Findings:
- The patient was diagnosed with celiac disease presenting with an unusual cutaneous manifestation of acquired ichthyosis.
- Treatment with a gluten-free diet, folic acid, and vitamin D led to the regression of secondary hyperparathyroidism.
- Significant improvement in the patient's skin symptoms was observed six months after dietary intervention.
Implications:
- This case highlights the importance of considering celiac disease in patients with unexplained acquired ichthyosis, even without typical gastrointestinal symptoms.
- Early diagnosis and management of celiac disease can lead to resolution of associated dermatological and endocrine complications.
- Further research into the pathogenesis of rare cutaneous manifestations of celiac disease is warranted.