Ichthyosis revealing coeliac disease

We describe the case of a twenty-nine year-old woman presenting a lamellar desquamation on the abdomen, submammary folds and on the limbs. During recent years the patient suffered neither from bowel disorders, nor from dryness of the skin. Laboratory tests revealed high values of parathormone and a high level of antiendomysial antibodies. The total bone-mineral density was about 78% of normal levels. A duodenal mucous membrane specimen showed total atrophy of the villi. Skin biopsy revealed an acquired ichthyosis mimicking an ichthyosis vulgaris. The patient underwent a gluten-free diet, supported by folic acid and vitamin D and six months later, after the regression of secondary hyperparathyroidism, a remarkable improvement of the cutaneous symptoms was obtained.