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Quality of Life and Gastrointestinal Symptoms in Long-Term Treated Dermatitis Herpetiformis Patients: A Cross-Sectional Study in Finland

Abstract

Background

Dermatitis herpetiformis (DH) is a cutaneous manifestation of celiac disease. Both conditions are treated with a restrictive life-long gluten-free diet (GFD). Treated celiac disease patients have been shown to have more severe gastrointestinal symptoms and inferior quality of life compared with healthy controls, but evidence regarding quality of life in DH is lacking.

Objective

The aim was to evaluate whether long-term GFD-treated DH patients suffer from persistent gastrointestinal symptoms and if they experience a drawdown in quality of life.

Methods

Gastrointestinal symptoms and quality of life were assessed in 78 long-term GFD-treated DH patients using the validated Gastrointestinal Symptom Rating Scale, Psychological General Well-Being and Short Form 36 Health Survey questionnaires. The findings were compared with 110 healthy controls, population-based reference values and 371 treated celiac disease controls.

Results

The median age of the DH patients at the time of the study was 57 years, and 51 % were male. Significant differences in gastrointestinal symptoms or quality of life were not detected when treated DH patients were compared with healthy controls, but treated DH patients had less severe gastrointestinal symptoms and increased quality of life compared with celiac disease controls. Female DH patients had more severe gastrointestinal symptoms and reduced vitality compared with male DH patients. The presence of skin symptoms and the adherence to or duration of GFD did not have any influence on gastrointestinal symptoms or quality of life.

Conclusion

We conclude that long-term GFD-treated DH patients do not suffer from the burden of dietary treatment and have a quality of life comparable to that of controls.

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Authors

Corresponding author

Correspondence to Teea Salmi.

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Funding

This study was financially supported by grants from the Academy of Finland, the Sigrid Juselius Foundation, the Finnish Medical Foundation, the Foundation for Paediatric Research, the Seppo Nieminen Fund and the Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital (Grant Number 9P060, 9P008, 9R018 and 9R034) and Seinäjoki Central Hospital (VTR16).

Conflict of interest

Camilla Pasternack, Katri Kaukinen, Kalle Kurppa, Markku Mäki, Pekka Collin, Timo Reunala, Heini Huhtala, and Teea Salmi have no conflicts of interest to declare.

Ethical approval

The study protocol was approved by the Regional Ethics Committee of Tampere University Hospital and has therefore been performed according to the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Pasternack, C., Kaukinen, K., Kurppa, K. et al. Quality of Life and Gastrointestinal Symptoms in Long-Term Treated Dermatitis Herpetiformis Patients: A Cross-Sectional Study in Finland. Am J Clin Dermatol 16, 545–552 (2015). https://doi.org/10.1007/s40257-015-0149-1

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Keywords

  • Celiac Disease
  • Celiac Disease Patient
  • Dermatitis Herpetiformis
  • Skin Symptom
  • Gastrointestinal Symptom Rate Scale