Dermatitis herpetiformis: consequences of elemental diet

The administration of an Elemental Diet to 5 patients with dermatitis herpetiformis, requiring high doses of Dapsone (diaminodiphenylsulfone, DDS), showed a rapid and beneficial effect on the skin lesions within two weeks. This effect was not influenced by simultaneous gluten challenge in one patient. A possible explanation is a reduction in the amount of harmful immune complexes due to the elimination of proteins from the diet. Subsequent introduction of a more comprehensive diet led to an increase of the minimal effective dose of Dapsone. These results underline the importance of dietary influences on the skin activity in dermatitis herpetiformis, other than gluten alone.