<abstract xmlns="http://www.w3.org/1999/xhtml"><p>Sarcoidosis is an enigmatic, multisystem granulomatous disease of unknown etiology and wide range of clinical presentations. Case report: A 54-year-old female presented with facial rash: polymorphic, round, infiltrated erythematous plaques, 1 - 3 cm in size, disseminated on several areas of the face. The medical history was consistent with dermatitis herpetiformis and persistent intrahepatic cholestasis. The laboratory test results suggested celiac disease (strong positivity of IgA anti-tissue transglutaminase antibodies) but upper endoscopy was not performed to confirm it. The skin biopsy revealed noncaseating epithelioid-cell granulomas, and negative direct immunofluorescence showed IgA deposits in the dermis. Sarcoidosis with cutaneous and hepatic involvement was established based on compatible clinical findings and supportive histology. The period between manifestations of Duhring disease and skin manifestations of sarcoidosis was 20 years. Conclusion: Our clinical case supports the hypothesis for common immune pathogenic factors in gluten-sensitive diseases and sarcoidosis. The simultaneous occurrence of celiac disease and sarcoidosis is rare, but should not be under recognized.</p></abstract>

Sarcoidosis is an enigmatic, multisystem granulomatous disease of unknown etiology and wide range of clinical presentations. Case report: A 54-year-old female presented with facial rash: polymorphic, round, infiltrated erythematous plaques, 1 - 3 cm in size, disseminated on several areas of the face. The medical history was consistent with dermatitis herpetiformis and persistent intrahepatic cholestasis. The laboratory test results suggested celiac disease (strong positivity of IgA anti-tissue transglutaminase antibodies) but upper endoscopy was not performed to confirm it. The skin biopsy revealed noncaseating epithelioid-cell granulomas, and negative direct immunofluorescence showed IgA deposits in the dermis. Sarcoidosis with cutaneous and hepatic involvement was established based on compatible clinical findings and supportive histology. The period between manifestations of Duhring disease and skin manifestations of sarcoidosis was 20 years. Conclusion: Our clinical case supports the hypothesis for common immune pathogenic factors in gluten-sensitive diseases and sarcoidosis. The simultaneous occurrence of celiac disease and sarcoidosis is rare, but should not be under recognized.

A Rare Comorbidity: Dermatitis Herpetiformis and Sarcoidosis - A Case Report

Clinic of Dermatology and Venereology, Medical University “Dr. Paraskev Stoyanov” - Varna,

Clinic of Gastroenterology, Medical University “Dr. Paraskev Stoyanov” - Varna,

Department of Pathology, Medical University “Dr. Paraskev Stoyanov” - Varna,

Serbian Journal of Dermatology and Venereology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

{"article-title":"A Rare Comorbidity: Dermatitis Herpetiformis and Sarcoidosis - A Case Report"}

Sarcoidosis is an enigmatic, multisystem granulomatous disease of unknown etiology and wide range of clinical presentations. Case report: A 54-year-old female...

A Rare Comorbidity: Dermatitis Herpetiformis and Sarcoidosis - A Case Report

Published Online: Mar 20, 2017

Page range: 171 - 176

DOI: https://doi.org/10.1515/sjdv-2016-0015

Keywords
Sarcoidosis, Dermatitis Herpetiformis, Comorbidity, Wheat Hypersensitivity, Diet, Gluten-Free, Epithelioid Cells, Granuloma, Case Reports

© 2016 Stoyan Ivanov Pavlov et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

A Rare Comorbidity: Dermatitis Herpetiformis and Sarcoidosis - A Case Report

Published Online: Mar 20, 2017

Page range: 171 - 176

DOI: https://doi.org/10.1515/sjdv-2016-0015

KeywordsSarcoidosis, Dermatitis Herpetiformis, Comorbidity, Wheat Hypersensitivity, Diet, Gluten-Free, Epithelioid Cells, Granuloma, Case Reports

© 2016 Stoyan Ivanov Pavlov et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
Sarcoidosis, Dermatitis Herpetiformis, Comorbidity, Wheat Hypersensitivity, Diet, Gluten-Free, Epithelioid Cells, Granuloma, Case Reports