Correlation of Vitamin D3 Levels and SCORAD Index in Atopic Dermatits: A Case Control Study

Abstract

INTRODUCTIONAD is a chronic relapsing eczematous skin disease characterized by pruritus and inflammation and accompanied by cutaneous physiological dysfunction [1]. Vitamin D deficiency is the pandemic and most under-diagnosed and under-treated nutritional deficiency in the world [2]. Vitamin D maintains the integrity of the permeability barrier, can stimulate or inhibit keratinocyte differentiation and stimulate synthesis of proteins such as filaggrin that are necessary for formation of stratum corneum barrier [3]. Statistics have shown a rising trend in the occurrence of AD in India in last four decades. Studies shows that vitamin D plays a role in AD pathogenesis mainly through its immunomodulatory action [4]. Most of data related to AD is available from hospital based studies [5]. SCORAD is a clinical tool used to assess the extent and severity of eczema [6].Peroni DG et al., found that vitamin D deficiency may be related to the severity of atopic dermatitis [7]. Han TY et al., conducted a study on 72 Korean childrens and adults it was found that serum-25 hydroxyvitamin D concentration was not significantly correlated with AD severity [8].Our study was a hospital based controlled cross-sectional study, a first of its kind in north western region of India. The aim of this study was to investigate the correlation between serum 25-hydroxyvitamin D {25(OH)D3} levels and SCORAD Index. MATERIALS AND METHODSIt was a controlled cross-sectional study conducted in the Department of Dermatology after taking approval from ethical committee. Eighty patients of either sex between age group of 2 to 18 years attending the outpatient department of skin and STD were enrolled. The study was conducted between the months of June 2016 to November 2016. These patients were divided into 2 groups, where, in group A, 40 patients of AD were taken according to the UK refinement of the Hanifin and Rajka diagnostic criteria [9] for atopic eczema and in group B, 40 patients of same age group were taken attending Skin and STD department with minor ailments like superficial bacterial, fungal or viral infections and not suffering from AD. Patients with any chronic dermatitis other than atopic dermatitis, patients with chronic medical illness like diabetes mellitus, hypertension and tuberculosis, patients with current consumption of vitamin D (within two months), patients receiving concomitant treatment with the ability to influence vitamin D3 and patients suffering from bowel disease with malabsorption of vitamin D3 were not included in the study groups.Physical and dermatological examination was done for every patient. The detailed history (age, sex, occupation, residence, total duration of disease, associated itching, seasonal variation, asthma, allergic rhinitis, atopy and family history of AD) was recorded in a proforma. The blood samples of all the cases and controls were assessed on the same day.The SCORAD index includes the assessment, by a physician, of objective signs (extent and intensity) and of subjective symptoms (pruritus and s...

A medium dose of UVA1 phototherapy does not diminish vitamin D level in patients with atopic dermatitis

“…Both recommended, and deficient and insufficient levels of vitamin D were similar before and after UVA1 phototherapy. There are studies that demonstrate significantly lower 25-hydroxy vitamin D 3 levels in patients with AD and a negative correlation between SCORAD and the serum vitamin D 3 level [40,41]. Accordingly, our study reveals a negative correlation between serum concentration of 25(OH)D and SCORAD index in patients with AD before UVA1 phototherapy.…”

“…Liczba osób, u których stężenie witaminy D było zgodne z zalecanym, a także osób z niedoborem i ciężkim niedoborem tej witaminy, była zbliżona przed rozpoczęciem fototerapii UVA1 oraz po jej zakończeniu. W piśmiennictwie dostępne są prace, w których wykazano istotnie niższe stężenie 25-hydroksywitaminy D 3 u pacjentów z AZS oraz ujemną korelację między wskaźnikiem SCORAD a stężeniem witaminy D 3 w surowicy [40,41]. Także w przeprowadzonym przez nas badaniu stwierdzono ujemną korelację między stężeniem 25(OH)D w surowicy a wartością wskaźnika SCORAD u pacjentów z AZS przed zastosowaniem fototerapii UVA1.…”

Clinical Characteristics of Pruritus in Systemic Sclerosis Vary According to the Autoimmune Subtype

“…Secondly, the ACA+ SSc subgroup is suspected to be more responsive to vitamin D supplementation, as the presence of ACA correlates with the normalization of vitamin D levels after supplementation (39). This is important, as an inverse relationship between serum levels of vitamin D and SCORAD index has been shown in atopic dermatitis (AD) (40). To our knowledge, LPA, vitamin D and other pruritogenic mediators of interest, such as IL-31, have not been associated with pruritus.…”

Does vitamin D deficiency increase severity of atopic dermatitis?

“…Sharma ve ark. (13) , Atopik dermatitli olgularda kontrol grubuna göre düşük D vitamini düzeyi saptarken, AD hastalık şiddeti ve D vitamini düzeyi arasında ters ilişki olduğunu bildirmişlerdir. Türkiye'de yapılan bir çalışmada, 60 atopik dermatitli çocuk ile 37 sağlıklı kontrol karşılaştırılmış, atopik dermatitli olgular ile kontrol grubu 25 (OH) D düzeyi arasında anlamlı fark bulunmazken, D vitamini düzeyi orta ve ağır AD'li olgularda hafif AD'li olgulara göre anlamlı düşük bulunmuştur (14) .…”

“…Bu veriler D vitamininin AD etyopatogenezini ve ağırlığını etkileyebileceği sorusunu gündeme getirmiştir. Son yıllarda AD hastalık şiddet skoru ile D vitamini düzeyi arasında pozitif korelasyon olduğunu bildiren yayınlar vardır (12)(13)(14)(15) .…”