Dermatitis herpetiformis. II. Het nut van een glutenvrij dieet

The beneficial effects of a gluten free diet on dermatitis herpetiformis (DH) have been known for several decades. In spite of this, many patients do not follow a diet, because dapsone therapy is effective enough or a diet is perceived to be too much of a burden. There are however several reasons to advise a gluten free diet to all patients with DH: (1) a gluten free diet is an effective treatment for DH; (2) strictly adhering to the diet will result in a decreased need for dapsone and often dapsone can in the long run be discontinued altogether; (3) all patients with DH also have celiac disease, which responds swiftly and well to a gluten free diet; (4) possibly the diet will offer some protection against the development of lymphoma. In order to optimize adherence to the diet the patient can best be referred to a dietician, and be advised to become a member of the Celiac Disease Patient Organisation. In addition, the patient should be monitored on a regular basis by the dermatologist and the gastroenterologist.