Risk of lymphoma in patients with dermatitis herpetiformis

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Abstract
Objective: To provide accurate estimates of the risk of lymphoma in patients with dermatitis herpetiformis. Design: Comparison of observed and expected incidence of cancer in patients with dermatitis herpetiformis. Subjects: 976 patients aged 4 to 97 years with no clinical signs of coeliac disease who were admitted to hospital between 1963 and 1983. Setting: Data from Swedish Cancer Registry. Main outcome measures: Incidence and type of cancer. Results: 106 cancers were diagnosed in 94 patients. The relative risk was 1.4 (95% confidence interval 1.1 to 1.7) in male patients and 1.2 (0.8 to 1.7) in female patients. When the individual cancer sites were analysed a significant risk was found only for malignant, non-Hodgkin's lymphoma in male patients, with a relative risk of 5.4 (2.2 to 11.1). Conclusions: The risk of lymphoma is greater in male patients with dermatitis herpetiformis, and this calls for increased surveillance in these patients.