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Related Experiment Videos

Small intestinal permeability in dermatological disease.

I Hamilton, G M Fairris, J Rothwell

    The Quarterly Journal of Medicine
    |September 1, 1985
    PubMed
    Summary

    Small intestinal permeability is generally normal in atopic eczema and psoriasis patients. Abnormal gut permeability may indicate gluten-sensitive enteropathy in dermatitis herpetiformis, potentially more sensitively than biopsies.

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    Area of Science:

    • Gastroenterology
    • Dermatology
    • Immunology

    Background:

    • Altered small intestinal permeability is hypothesized to contribute to inflammatory skin conditions.
    • The role of gut integrity in atopic eczema, psoriasis, and dermatitis herpetiformis remains unclear.

    Purpose of the Study:

    • To investigate passive small intestinal permeability in patients with atopic eczema, psoriasis, and dermatitis herpetiformis.
    • To determine if abnormal intestinal permeability is linked to the pathogenesis of these skin diseases.

    Main Methods:

    • Utilized the cellobiose/mannitol differential sugar absorption test in 62 patients with atopic eczema, 29 with psoriasis, and 18 with dermatitis herpetiformis.
    • Assessed urinary recovery of cellobiose and mannitol, and the recovery ratio.
    • Performed jejunal biopsies in a subset of patients with abnormal permeability.

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    Main Results:

    • The cellobiose/mannitol recovery ratio was normal in most patients with atopic eczema and psoriasis, irrespective of disease severity.
    • Abnormal permeability was observed in a minority of eczema and psoriasis patients; one eczema patient had coeliac disease.
    • Abnormal permeability was noted in 11 dermatitis herpetiformis patients, with normal jejunal biopsies in seven, suggesting potential gluten sensitivity.

    Conclusions:

    • Passive small intestinal permeability is typically normal in atopic eczema and psoriasis.
    • Defective intestinal integrity is unlikely to be a primary factor in the pathogenesis of eczema.
    • Elevated intestinal permeability may be an early indicator of gluten-sensitive enteropathy in dermatitis herpetiformis, potentially preceding histological changes.