Eczema & Celiac Disease: Is There a Link?
Epidemiological Association
- Children with eczema: ~10% have celiac disease vs. ~1% in general pediatric population.
- Celiac patients show higher eczema prevalence than controls.
Proposed Mechanisms
- Shared autoimmune dysregulation: Both involve Th2/Th17 pathways, barrier dysfunction (skin/gut), and loss of tolerance.
- Genetic overlap: HLA-DQ2/DQ8 haplotypes; mutations in FLG (filagrin) and immune-regulation genes.
- Nutrient malabsorption: Celiac-related deficiencies (zinc, vitamin D, essential fatty acids) may exacerbate eczema.
Clinical Takeaway
If eczema is refractory or accompanied by GI symptoms (diarrhea, bloating, weight loss, iron-deficiency anemia), screen for celiac disease (tTG-IgA, total IgA, confirmatory biopsy). A gluten-free trial should only follow confirmed diagnosis.
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