Analysis of the Correlation Between Serum Vitamin D Levels and Severity of Atopic Dermatitis
Abstract
Introduction: Atopic dermatitis (AD) is a chronic inflammatory multifactorial disease. Severe cases affect the quality of life. The pathogenesis is complex, marked by defective cellular immune system, exacerbation of Th2-type immune response and impaired skin barrier function. Studies suggest that vitamin D acts in the regulation of the innate and adaptive immune response, reduces the inflammatory process and improves the skin barrier. Our objective was to correlate vitamin D serum levels with the severity of AD.
Material and Methods: Between 2015 and 2018 the authors evaluated 30 patients aged between 18 and 90 years old, under treatment at a Dermatology ambulatory clinic. Patients were divided into 2 groups: mild disease (only topical therapy) and moderate to severe disease (under immunosuppressive treatment).
Results: Ten cases with mild AD and 20 with moderate to severe AD were selected. Among patients with mild disease, 20% had vitamin D deficiency. As for patients with moderate to severe disease, 40% had a deficient serum level of 25-hydroxyvitamin D. Comparing the average vitamin D in the two groups, there was no statistical difference between them.
Conclusion: In the literature, the association between vitamin D levels and the severity of AD remain controversial, although some studies support this association. In this study, despite the proportion of patients with 25-hydroxyvitamin D deficiency being twice as high among patients with moderate to severe AD, there was no statistical significance between the groups, corroborating previous manuscripts. Clinical studies relating atopic dermatitis to vitamin D are warranted, considering its possible use as a concomitant therapy.
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References
Borzutzky A, Camargo CA Jr. Role of vitamin D in the pathogenesis and treatment of atopic dermatitis. Expert Rev Clin Immunol. 2013;9(8):751-760. https://doi.org/10.1586/1744666X.2013.816493
Dogru M. Is vitamin D level associated with the natural course of atopic dermatitis?. Allergol Immunopathol (Madr). 2018;46(6):546-551. https://doi.org/10.1016/j.aller.2017.12.004
Williamson S, Merritt J, De Benedetto A. Atopic dermatitis in the elderly: a review of clinical and pathophysiological hallmarks. Br J Dermatol. 2020;182(1):47-54. https://doi.org/10.1111/bjd.17896
Mesquita Kde C, Igreja AC, Costa IM. Ultraviolet index: a light in atopic dermatitis and vitamin D research?. An Bras Dermatol. 2016;91(1):34-39. https://doi.org/10.1590/abd1806-4841.20164337
Amon U, Baier L, Yaguboglu R, Ennis M, Holick MF, Amon J. Serum 25-hydroxyvitamin D levels in patients with skin diseases including psoriasis, infections, and atopic dermatitis. Dermatoendocrinol. 2018;10(1):e1442159. https://doi.org/10.1080/19381980.2018.1442159
Camargo CA Jr, Ganmaa D, Sidbury R, Erdenedelger Kh, Radnaakhand N, Khandsuren B. Randomized trial of vitamin D supplementation for winter-related atopic dermatitis in children. J Allergy Clin Immunol. 2014;134(4):831-835.e1. https://doi.org/10.1016/j.jaci.2014.08.002
Han TY, Kong TS, Kim MH, Chae JD, Lee JH, Son SJ. Vitamin D Status and Its Association with the SCORAD Score and Serum LL-37 Level in Korean Adults and Children with Atopic Dermatitis. Ann Dermatol. 2015;27(1):10-14. https://doi.org/10.5021/ad.2015.27.1.10
Chiu YE, Havens PL, Siegel DH, Ali O, Wang T, Holland KE, et al. Serum 25-hydroxyvitamin D concentration does not correlate with atopic dermatitis severity. J Am Acad Dermatol. 2013;69(1):40-6. https://doi.org/10.1016/j.jaad.2013.01.010
Huang CM, Lara-Corrales I, Pope E. Effects of Vitamin D levels and supplementation on atopic dermatitis: A systematic review. Pediatr Dermatol. 2018;35(6):754-760. https://doi.org/10.1111/pde.13639
Heine G, Hoefer N, Franke A, Nöthling U, Schumann RR, Hamann L, et al. Association of vitamin D receptor gene polymorphisms with severe atopic dermatitis in adults. Br J Dermatol. 2013;168(4):855-858. https://doi.org/10.1111/bjd.12077
Peroni DG, Piacentini GL, Cametti E, Chinellato I, Boner AL. Correlation between serum 25-hydroxyvitamin D levels and severity of atopic dermatitis in children. Br J Dermatol. 2011;164(5):1078-1082. https://doi.org/10.1111/j.1365-2133.2010.10147.x
Wang SS, Hon KL, Kong AP, Pong HN, Wong GW, Leung TF. Vitamin D deficiency is associated with diagnosis and severity of childhood atopic dermatitis. Pediatr Allergy Immunol. 2014;25(1):30-35. https://doi.org/10.1111/pai.12167
Robl R, Uber M, Abagge KT, Lima MN, Carvalho VO. Serum Vitamin D Levels Not Associated with Atopic Dermatitis Severity. Pediatr Dermatol. 2016;33(3):283-288. https://doi.org/10.1111/pde.12795
van der Schaft J, Ariens LF, Bruijnzeel-Koomen CA, de Bruin-Weller MS. Serum vitamin D status in adult patients with atopic dermatitis: Recommendations for daily practice. J Am Acad Dermatol. 2016;75(6):1257-1259. https://doi.org/10.1016/j.jaad.2016.07.035
Haeck IM, Hamdy NA, Timmer-de Mik L, Lentjes EG, Verhaar HJ, Knol MJ, et al. Low bone mineral density in adult patients with moderate to severe atopic dermatitis. Br J Dermatol. 2009;161(6):1248-1254. https://doi.org/10.1111/j.1365-2133.2009.09327.x
Garg N, Silverberg JI. Association Between Eczema and Increased Fracture and Bone or Joint Injury in Adults: A US Population-Based Study. JAMA Dermatol. 2015;151(1):33–41. https://doi.org/10.1001/jamadermatol.2014.2098
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