European Journal of Dermatology

, Volume 27, Issue 4, pp 353–358 | Cite as

Dermatitis herpetiformis and bone mineral density: analysis of a French cohort of 53 patients

  • Coralie Lheure
  • Saskia Ingen-Housz-Oro
  • Sandra Guignard
  • Rachida Inaoui
  • Brigitte Jolivet
  • Xavier Chevalier
  • Pierre Wolkenstein
  • Bruno Fautrel
  • Oliver Chosidow
Investigative report

Abstract

Background

The characteristics of patients with dermatitis herpetiformis (DH) in France is poorly documented. Furthermore, the risk of fractures and bone mineral density (BMD) in DH remain under-described, and recommendations for systematic screening for osteoporosis in DH are lacking.

Objectives

To describe the characteristics of DH in a large French cohort and evaluate the association between BMD and features of osteoporosis.

Materials and methods

Patients were recruited from the French Association of Gluten Intolerants (AFDIAG) and a single university dermatology department. A telephone questionnaire was used to record features of DH, history of fractures, calcium intake, treatment, and the gluten-free diet (GFD). Serum calcium and 25(OH) vitamin D3+D2 levels, as well as BMD, were measured.

Results

We included 53 patients (27 men) with a median age of 49 years (range: 23-86). Median disease duration before inclusion was 14 years (range: 2-55); 51 patients (96%) were adherent to a GFD and had no digestive symptoms. Overall, 18 (34%) had a history of fractures; 16 high-velocity (traumatic) and two low-velocity (nontraumatic). Mean BMD, measured in 48 patients, was normal (femoral neck: 0.956 ± 0.210 g/cm2; lumbar spine: 1.091 ± 1.199 g/cm2). In all, 18 patients (38%) had osteopenia and one (2%) osteoporosis. T-score for bone density did not differ with and without fractures. Calcium intake and serum calcium level were normal in all patients.

Conclusion

Screening for osteoporosis does not appear to be mandatory for DH patients with good adherence to a GFD and without digestive symptoms or additional risk factors of osteoporosis.

Key words

dermatitis herpetiformis bone mineral density fracture France gluten-free gluten intolerant 

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Copyright information

© John Libbey Eurotext 2017

Authors and Affiliations

  • Coralie Lheure
    • 1
  • Saskia Ingen-Housz-Oro
    • 1
    • 2
  • Sandra Guignard
    • 3
  • Rachida Inaoui
    • 4
  • Brigitte Jolivet
    • 5
  • Xavier Chevalier
    • 3
  • Pierre Wolkenstein
    • 1
    • 6
  • Bruno Fautrel
    • 4
    • 7
  • Oliver Chosidow
    • 1
    • 2
    • 6
    • 8
  1. 1.Assistance Publique-Hôpitaux de Paris (APHP), Department of DermatologyHenri Mondor HospitalCréteilFrance
  2. 2.EA 7379 EpiDermE (Epidémiologie en Dermatologie et Evaluation des Thérapeutiques)UPECCréteilFrance
  3. 3.Assistance Publique-Hôpitaux de Paris (APHP), Department of RumathologyHôpital Henri MondorCréteilFrance
  4. 4.Assistance Publique-Hôpitaux de Paris (APHP), Department of RumathologyHôpital La Pitié SalpêtrièreParisFrance
  5. 5.Association Française des Intolérants au GlutenParisFrance
  6. 6.Université Paris-Est Créteil Val de Marne (UPEC)CréteilFrance
  7. 7.GRC-UPMC 08 (EEMOIS), Institut Pierre-Louis d’Epidémiologie et de Santé PubliqueSorbonne Université, UMPC Université ParisParisFrance
  8. 8.Centre d’Investigation Clinique 1430, AP-HPCréteilFrance

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