Nutrients. 2021 Oct 15;13(10):3611. doi: 10.3390/nu13103611.

Flavia Persechino ¹, Gloria Galli ², Severino Persechino ³, Francesco Valitutti ⁴, Letizia Zenzeri ^5 6, Angela Mauro ⁵, Vito Domenico Corleto ², Pasquale Parisi ⁶, Chiara Ziparo ⁶, Melania Evangelisti ⁶, Giovanna Quatrale ⁶, Giovanni Di Nardo ⁶

Author information

• ¹Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy.
• ²Department of Medical-Surgical and Translational Medicine, Sant'Andrea University Hospital, Sapienza University of Rome, 00185 Rome, Italy.
• ³Dermatology Unit, NESMOS Department, Faculty of Medicine & Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, 00185 Rome, Italy.
• ⁴Pediatric Unit, AOU San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy and EBRIS (European Biomedical Research Institute of Salerno), 84121 Salerno, Italy.
• ⁵Pediatric Emergency Unit, Emergency Pediatric Department, AORN Santobono-Pausilipon Children's Hospital, 80129 Naples, Italy.
• ⁶Pediatric Unit, NESMOS Department, Faculty of Medicine & Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, 00185 Rome, Italy.

Abstract

Celiac disease (CD) is an immune-mediated enteropathy caused by gluten ingestion, affecting approximately 1% of the worldwide population. Extraintestinal symptoms may be present as the first signs of CD, years before the CD diagnosis is made. A great variety of extraintestinal manifestations may be associated with CD. Cutaneous manifestations represent the main extraintestinal manifestations, with dermatitis herpetiformis being the most common in patients with CD. In adults, it has been demonstrated that the role of a gluten-free diet is crucial not only for the recovery of signs and symptoms associated with CD but also for cutaneous manifestations, which often improve after gluten avoidance. In children with CD, the association with skin disorders is well documented regarding dermatitis herpetiformis, but studies considering other dermatological conditions, such as psoriasis and atopic dermatitis, are few. The prevalence and manifestations of dermatological disorders in celiac children are often different from those in adults, explaining the gap between these populations. In addition, the therapeutic role of a gluten-free diet in the improvement in skin alterations is not fully understood in children and in adult population except for dermatitis herpetiformis. Therefore, cutaneous CD symptoms need to be known and recognized by physicians despite their specialties to improve early CD diagnosis, which is critical for a better prognosis. This review describes the current scientific evidence on skin manifestations associated with CD in the pediatric population.