RISK-FACTORS FOR ISCHEMIC-HEART-DISEASE IN PATIENTS WITH DERMATITIS-HERPETIFORMIS

For reasons that are unclear, patients with dermatitis herpetiformis ( DH) have a lower than expected mortality rate from ischaemic heart dis ease, We have compared risk factors for ischaemic heart disease (lipid s, fibrinogen levels, smoking history and social class) in 29 DH patie nts and 57 controls matched for age and sex. Patients with DH had sign ificantly lower cholesterol, triglycerides, apolipoprotein B and fibri nogen and higher HDL2; they also smoked less and were of higher social class. The mechanisms underlying these observations merit further inv estigation, Intestinal abnormalities or gluten-free diet may account f or differences in lipid fractions, and the immunomodulatory properties of cigarette smoke may protect against the development of DH.