Skin manifestations in individuals with undiagnosed celiac seropositivity: a cross-sectional study

Scand J Gastroenterol. 2026 Jan;61(1):1-9. doi: 10.1080/00365521.2025.2598108. Epub 2025 Dec 9.

Abstract

Background: Celiac disease (CD) is an underdiagnosed disease with a significant diagnostic delay. Previous studies have shown associations between CD and several skin diseases.

Objective: The objective of this article was to investigate the association between undiagnosed celiac seropositivity and prevalence of self-reported skin symptoms and diseases in adults.

Methods: In a Danish population-based cohort comprising 9656 participants, we identified individuals with undiagnosed celiac seropositivity, defined by celiac antibody positivity against immunoglobulin (Ig) A and/or IgG tissue transglutaminase (TTG) ≥7 U/mL and/or IgG deamidated gliadin peptide ≥10 U/mL, without a known diagnosis of CD in the National Patient Register. Information on skin symptoms and diseases were obtained from participant-completed questionnaires. The associations between skin symptoms and diseases and undiagnosed celiac seropositivity were analyzed by 2 or Fisher's exact test and logistic regression were used to calculate odds ratios (OR) with 95% confidence intervals (CI).

Results: We excluded 13 participants with a previous CD diagnosis and 386 participants due to missing measurements of CD antibodies, resulting in a study population of 9257 participants. In this population, 0.76% (70/9257) had undiagnosed celiac seropositivity. There were no statistically significant differences in skin symptoms and diseases between participants with and without undiagnosed celiac seropositivity; the OR for any skin symptom or disease was 0.83 (95% CI: 0.41-1.67) among individuals with undiagnosed celiac seropositivity compared with individuals without.

Conclusion: In this cross-sectional study, we found no differences in self-reported skin symptoms and diseases between participants with and without undiagnosed celiac seropositivity.

Keywords: Celiac disease; celiac disease seropositivity; health-examination survey; population-based; skin manifestations.

MeSH terms

  • Adult
  • Aged
  • Autoantibodies / blood
  • Celiac Disease* / complications
  • Celiac Disease* / diagnosis
  • Celiac Disease* / epidemiology
  • Celiac Disease* / immunology
  • Cross-Sectional Studies
  • Denmark / epidemiology
  • Female
  • GTP-Binding Proteins / immunology
  • Gliadin / immunology
  • Humans
  • Immunoglobulin A / blood
  • Immunoglobulin G / blood
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Prevalence
  • Protein Glutamine gamma Glutamyltransferase 2
  • Self Report
  • Skin Diseases* / epidemiology
  • Skin Diseases* / etiology
  • Transglutaminases / immunology
  • Young Adult

Substances

  • Transglutaminases
  • Immunoglobulin G
  • Immunoglobulin A
  • Gliadin
  • Protein Glutamine gamma Glutamyltransferase 2
  • GTP-Binding Proteins
  • Autoantibodies