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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA
A Journal on Dermatology and Sexually Transmitted Diseases
Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Giornale Italiano di Dermatologia e Venereologia 2006 December;141(6):525-8
Coeliac disease associated with sclerodermia. A study of two cases
Mozzillo R., Colasanti P., Cordedda M., Zanchini R., Berruti V.
Unit of Dermatology, S. Gennaro Hospital Azienda Sanitaria Locale Napoli 1, Naples, Italy
Coeliac disease is characterised by gluten intolerance which determines malabsorption, owing to atrophy of the villi of the small intestine. It is caused by the inappropriate activation of certain immune responses, the mechanism of which is still unclear. It has an estimated prevalence in western countries of between 0.3% and 0.5%. Numerous autoimmune-based disorders, such as connective tissue disease, thyroiditis and a number of dermatoses may be associated with coeliac disease. The authors report the cases of a 21-year-old woman and a 12-year-old girl affected by scleroderma and celiac disease. The peculiarity of the cases is the rareness of the association; moreover, it is interesting to reflect on the clinical and immunopathogenetic links between scleroderma and celiac disease. Our own experience and reports in the literature show that the prevalence of autoimmune disorders in celiac disease is related to the patient’s age at diagnosis. The relationship has been explained by the duration of exposure to gluten. In celiac disease local immune reaction, besides causing injury to the intestinal mucosa, also increases intestinal permeability, thus promoting the development of new autoimmune reactions. Based on this evidence, it can be hypothesised that the introduction of a gluten-free diet and the subsequent recovery of the integrity of the intestinal mucosa may slow down the evolution of scleroderma.