Dermatitis herpetiformis. III. Het risico op lymfomen en andere maligniteiten

In this article on the relation between dermatitis herpetiformis (DH) and malignancies, especially lympho-mas, we attempt - based on a critical review of the literature - to answer the following questions: (1) Do patients with DH have an increased risk of developing lymphomas?; (2) are these always enteropathy-associated T-cell lymphomas?; (3) Are DH patients at risk of developing malignancies other than lymphomas?; (4) does a gluten free diet protect against the development of lymphomas? Male DH patients probably have a slightly increased risk of developing non-Hodgkin lymphomas; for women an increased risk has not been established. In absolute numbers the increase is very modest and therefore, patients need not to be warned nor are diagnostic procedures for the early detection of lymphomas necessary. Lymphomas in DH patients can both be B-cell and T-cell lymphomas and are usually located in the gut (but not specifically in the small intestine) or in the lymph nodes. Patients with DH do not have an increased risk of malignancies other than lymphomas. There are some indications that a gluten free diet may have a protective effect against lymphomas developing.