The role of gluten in the pathophysiology of dermatitis herpetiformis was clearly presented in our article,1 complete with references to articles by Drs Fry and Leonard. To state that the cause of the disorder is gluten is, however, simplistic, even misleading, since most people include gluten in their diets on a daily basis without development of this disease. The cause of dermatitis herpetiformis resides in an abnormal immune response to gluten that is yet to be elucidated.
Olbricht SM, Harrist TJ. The Cause of Dermatitis Herpetiformis-Reply. Arch Dermatol. 1987;123(3):293. doi:10.1001/archderm.1987.01660270025003