Lymphoma in dermatitis herpetiformis: report on four cases.

Four patients suffering from protracted dermatitis herpetiformis (DH) developed lymphomas while undergoing gluten-free diet treatment. This had lasted between 6 months and 4 years. The first patient died of histiocytic lymphoma involving mesenterial lymph nodes, liver, spleen and blood marrow. The second patient died of histiocytic lymphoma disseminated in the ileum, colon, stomach and mesenterium. This patient had been operated on 14 years earlier for a solitary ulcerating lymphoma in the ileum. The third patient had a localized histiocytic lymphoma in the colon. This was successfully removed by hemicholectomy. The fourth patient had a lymphocytic lymphoma of B-cell origin in the inguinal lymph nodes which was treated with radiotherapy. These 4 patients with lymphomas suggest that, like coeliac disease patients, DH patients also run an increased risk of developing lymphomas.