Remission possible for some dermatitis herpetiformis patients

Bethesda, Md. - A new study by the National Institutes of Health suggests that a small percentage of people with dermatitis herpetiformis may eventually go into spontaneous remission, and be able to wean off medication and a gluten-free diet, Reuters Health reports.

Patients with the autoimmune condition develop blisters, itching and burning, primarily on the elbows, knees and buttocks. The disorder is treated with sulfones (which put patients at risk for anemia) and a strict gluten-free diet.

The study focused on 86 patients with dermatitis herpetiformis. Of that total, 10 experienced no return of symptoms after they were weaned off their medication and resumed a normal diet.

Study author Stephen Katz, M.D., reports that in his practice, he tries to slowly wean his patients off sulfones over a multi-year period, advising them to eat small amounts of gluten and see if their symptoms return.

Reuters Health quotes Dr. Katz as saying, “I always tell them to cheat a little bit, see if they need the diet, because if some patients don’t need the medicine, they may no longer need the diet.”

There were, however, no obvious differences between the study patients who went into remission and those who didn’t - a factor that Dr. Katz notes is puzzling. There is also concern that patients who go off the diet may have a higher risk of lymphoma and other complications.

A physician who reviewed the study for Reuters Health suggests that patients with dermatitis herpetiformis who decide to stop the diet should undergo regular blood tests for celiac antibodies, even if their skin symptoms never return.