Association between celiac disease and vitiligo:A review of the literature

Celiac disease(CD)is an autoimmune intestinal disease caused by the intake of gluten-containing cereals and their products by individuals with genetic susceptibility genes.Vitiligo is a commonly acquired depigmentation of the skin;its clinical manifestation are skin patches caused by localized or generalized melanin deficiency.Both diseases have similar global incidence rates(approximately 1%)and are associated to similar diseases,including autoimmune bullous disease,inflammatory bowel disease,autoimmune thyroiditis,autoimmune gastritis,and type 1 diabetes.The relationship between CD and vitiligo has been reported in several studies,but their conclusions are inconsistent.Further,it has also been reported that a gluten-free diet(GFD)can improve the symptoms of immunerelated skin diseases such as vitiligo.In this mini-review,we summarize and review the literature on the relationship between CD and vitiligo,assess the therapeutic significance of GFD for patients with vitiligo,and explore their possible physiopathology.We are hopeful that the information summarized here will assist physicians who treat patients with CD or vitiligo,thereby improving the prognosis.

Bullous Pemphigoid With Nail Damage Associated With Kaposi Sarcoma:A Case Report

Introduction:Bullous pemphigoid is an acquired autoimmune bullous skin disease that occurs in the elderly,and nail involvement is relatively rare.Kaposi sarcoma(KS) is a rare opportunistic tumor in patients with iatrogenic immunosuppression and is rarely associated with autoimmune bullotic disease.Case presentation:The patient was diagnosed with bullous pemphigoid based on her history,bullous pemphigoid antibody,and skin pathological examination.And nail involvement occurred 20 days prior to the recurrence of the disease.Moreover,KS occurred during high-dose glucocorticoid therapy in this patient.Discussion:The patient was admitted to hospital because of a five-month history of erythema and blisters and a one-month history of nodules and plaques.The diagnosis of bullous pemphigoid was followed by treatment with glucocorticoids and intravenous gamma globulin.During treatment,the disease recurred due to discontinuation of glucocorticoids.There were erythema and blisters all over the body,and purple nodules,plaques appeared in the base of some blisters.Pathological examination of nodules was consistent with KS.In addition,nail involvement occurred 20 days before recurrence.The particularity of this case lies in the simultaneous occurrence of nail involvement,bullous pemphigoid,and KS.Conclusion:Patients with autoimmune bullous skin disease may suddenly develop abnormal nails,and such patients should be vigilant about recurrence of the disease.Doctors should be aware of the possibility of KS when rapidly progressing purplish red plaques or nodules appear in patients receiving high doses of corticosteroids or immunosuppressants.