Helicobacter pylori infection and skin diseases

There is increasing evidence for systemic effects of gastric H. pylori infe ction which may result in extragastrointestinal disorders. This review summ arizes the available medical literature up to September 1999, identified th rough a MEDLINE research including own regarding H. pylori and skin disease s. Due to current knowledge best evidence for a potential link of H. pylori infection exists for chronic urticaria although the data are still conflic ting. Thus, the search for H. pylori should be included in the diagnostic m anagement of chronic urticaria. With regard to other skin diseases such as rosacea, hereditary or acquired angioedema due to C1-esterase inhibitor def iciency, systemic sclerosis, Schonlein-Henoch purpura, Sjogren's syndrome, sweet's syndrome, and atopic dermatitis only single of few cases have been reported so far. Thus, we clearly need further randomized, double-blind and placebo-controlled studies including adequate diagnostic schedules, suffic ient eradication treatment protocols, confirmation of eradication, and adeq uate control groups to establish a role of H. pylori in skin diseases. Caut ion must be taken not to accuse H. pylori as the infectious agent responsib le for every disease, particularly since H. pylori infection is very common . Although from an epidemiological and morphological view the skin diseases to which H. pylori has been linked seem to be completely different it is s triking that in most of them an autoimmune pathogenesis is suspected or con siderable vascular impairment can be found.