To the Editor.—
In our modern climate of increased awareness of health and personal appearance, a seemingly endless number of special diets have been developed to foster weight loss. Recently, a patient with previously untreated dermatitis herpetiformis had the good fortune of being placed on such a diet to treat coexistent morbid obesity. As the exclusively protein diet contained no gluten, his skin disease resolved rapidly, before dapsone therapy could be initiated.
Report of a Case.—
A 42-year-old man was referred for evaluation of an asymptomatic elbow rash of several months' duration. The patient weighed 135 kg (296 pounds) but was otherwise in good health and taking no oral medications. Examination of the skin revealed plaques of clustered vesicles on an erythematous base covering both elbows. The clinical diagnosis of dermatitis herpetiformis was confirmed histopathologically with the presence of granular IgA and C3 at the basement membrane zone on immunofluorescent
Gross AS, King LE, Patten WT. Gluten-Free Diet in Dermatitis Herpetiformis. Arch Dermatol. 1991;127(2):273–274. doi:10.1001/archderm.1991.01680020145032