Atopic dermatitis and vitamin D: facts and controversies

Abstract

Patients with atopic dermatitis have genetically determined risk factors that affect the barrier function of the skin and immune responses that interact with environmental factors. Clinically, this results in an intensely pruriginous and inflamed skin that allows the penetration of irritants and allergens and predisposes patients to colonization and infection by microorganisms. Among the various etiological factors responsible for the increased prevalence of atopic diseases over the past few decades, the role of vitamin D has been emphasized. As the pathogenesis of AD involves a complex interplay of epidermal barrier dysfunction and dysregulated immune response, and vitamin D is involved in both processes, it is reasonable to expect that vitamin D's status could be associated with atopic dermatitis' risk or severity. Such association is suggested by epidemiological and experimental data. In this review, we will discuss the evidence for and against this controversial relationship, emphasizing the possible etiopathogenic mechanisms involved.

House Dust Mite Sensitization Is Inversely Associated with Plasma 25-Hydroxyvitamin D3 Levels in Patients with Severe Atopic Dermatitis

“…Overall, it seems that a predominance of reports points to a negative association between serum vitamin D levels and AD severity41015. However, in our study, serum vitamin D levels were not correlated with AD severity.…”

Epidermal Barrier: Negative Changes in Atopic Dermatitis and Positive Changes Induced by Short-term Suberythemal Ultraviolet B Irradiation

“…In intertropical zones (between latitudes 23.5°N and 23.5°S), UVB rays are more intense and vitamin D synthesis is possible throughout the year [1]. In temperate zones (23.5°-66.5°), people lack sufficient UVB for vitamin D synthesis for 1 month during the year, while those closer to the poles do not get enough UVB radiation for most of the year [1,[48][49][50].…”

“…In temperate zones (23.5°-66.5°), people lack sufficient UVB for vitamin D synthesis for 1 month during the year, while those closer to the poles do not get enough UVB radiation for most of the year [1,[48][49][50]. It is also influenced by the season of the year, with a seasonal decline occurring in winter [1,51], the same season of the year when Atopic Dermatitis (AD) becomes worse or more prevalent. [52].…”

“…It has been observed by many that AD becomes more prevalent in winter, when people lack sufficient Ultraviolet B (UVB) for vitamin D synthesis [1]. Thus, UVB radiation has been applied for the treatment of AD [2][3][4].…”

Parathyroid Hormone: An Overlooked Variable in Atopic Dermatitis and Vitamin D Research

“…The relationship between AD and 25(OH)D is controversial, and negative and positive associations have been reported. Vitamin D deficiency has not been proven to cause or exacerbate atopic dermatitis .…”