Dermatitis Herpetiformis: Risk for Bone Loss

People with the 'gluten rash' may be at risk for thinning bones. PASEIKA/Getty Images

July 7, 2013 — It's well-known that people with celiac disease are at risk for low bone density and the bone loss conditions osteopenia and osteoporosis. Now, a study confirms that those with dermatitis herpetiformis, the almost unbearably itchy rash associated with celiac, also are at risk for having low bone mass.

The study, published in the Spanish medical journal Revista Espanola de enfermadades digestivas, looked at 53 people with biopsy-confirmed dermatitis herpetiformis, comparing them with 34 celiacs and 42 people without either condition.

One-third of those with dermatitis herpetiformis were not following a strict gluten-free diet.

The researchers measured bone mineral density at three places in each person: the lumbar spine (the lower back), the left femoral neck (in the hip) and the radius (the larger of two bones in the forearm). They also performed biopsies to evaluate everyone in the study for villous atrophy (the measure of intestinal damage used in celiac disease).

Results Show Bone Loss in Rash, Too

People with celiac disease fared worse than those with dermatitis herpetiformis on all measures, the study reported. For example, slightly fewer than half of those with dermatitis herpetiformis had low bone mineral density in their lumbar spine, compared with more than two-thirds of those with celiac disease and 29% of people without either condition.

In addition, 21% of dermatitis herpetiformis patients had a low bone mineral density at the femoral neck, compared with half of celiacs.

And, 58% of those with dermatitis herpetiformis had low bone mineral density in their radius, compared with 71% of those with celiac disease.

"Bone mineral content in patients with dermatitis herpetiformis was significantly lower than in healthy controls but higher than in celiac disease," the researchers concluded.

Those with dermatitis herpetiformis tended to have less intestinal damage than those with celiac disease, but the study didn't show a clear relationship between the severity of villous atrophy and bone density.

The bottom line? People with dermatitis herpetiformis may want to speak with their physicians about having their bone density measured, and potentially take steps to correct any problems found.

More on dermatitis herpetiformis:


Lorinczy K et al. Does dermatitis herpetiformis result in bone loss as coeliac disease does? A cross-sectional studyRevista Espanola de enfermadades digestivas. 2013 Apr;105(4):187-93.

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