What symptom is closely linked to celiac disease alongside flattening of the villi?

Dermatitis herpetiformis is closely linked to celiac disease, as it is considered a skin manifestation of the condition. This autoimmune disorder occurs in individuals who are sensitive to gluten, and it is characterized by an itchy, blistering rash that typically appears on the elbows, knees, and buttocks. The association between dermatitis herpetiformis and celiac disease is significant because both involve the immune system reacting improperly to gluten, which leads to both intestinal damage (flattening of the villi) and skin symptoms.

When people with celiac disease consume gluten, the immune response can not only affect the intestines but also trigger lesions in the skin that resemble those seen in herpes infections, hence the name "herpetiformis." The diagnosis of dermatitis herpetiformis often leads to testing for celiac disease, as it is one of the hallmark presentations of gluten sensitivity.

In contrast, the other conditions listed are not directly associated with celiac disease. Psoriasis is a chronic inflammatory skin condition not specifically related to gluten. Erythema nodosum is a form of inflammatory reaction that can occur in various diseases but is not a typical manifestation of celiac disease. Acanthosis nigricans is associated with insulin resistance and