ORIGINAL ARTICLE

Correlation of low vitamin D status with atopic dermatitis severity in children

Habibah Hasyim Lubis , Kristo Alberto Nababan, Deryne Anggia Paramita

Habibah Hasyim Lubis
Postgraduate Master of Clinical Medicine Department of Dermatology and Venereology, Faculty of Medicine, Universitas Sumatera Utara, Universitas Sumatera Utara Hospital, Medan, Indonesia. Email: drhabibahhasyim@gmail.com

Kristo Alberto Nababan
Department of Dermatology and Venereology, Faculty of Medicine, Universitas Sumatera Utara, Universitas Sumatera Utara Hospital, Medan, Indonesia Medan, Indonesia

Deryne Anggia Paramita
Department of Dermatology and Venereology, Faculty of Medicine, Universitas Sumatera Utara, Universitas Sumatera Utara Hospital, Medan, Indonesia Medan, Indonesia
Online First: April 30, 2021 | Cite this Article
Lubis, H., Nababan, K., Paramita, D. 2021. Correlation of low vitamin D status with atopic dermatitis severity in children. Bali Medical Journal 10(1): 291-295. DOI:10.15562/bmj.v10i1.2203


Introduction: Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disorder. Vitamin D has some roles in immunologic mechanisms. Vitamin D may influence the severity of AD. Previous studies of vitamin D correlation in children with atopic dermatitis have revealed conflicting results. This study determines the correlation between low vitamin D status with the severity of atopic dermatitis in children. 

Methods: This is a cross-sectional analytical study with a cross-sectional approach that involved DA subjects aged ≤17 years with low vitamin D status. The recording of basics data and examination of subjects included assessing the scoring atopic dermatitis (SCORAD) score and measuring 25-hydroxyvitamin D (25(OH)D) level for all subjects. Statistical analyses were performed using Pearson's correlation coefficients, with P<0.05 was considered statistically significant. 

Result: A total of 30 subjects with AD with the most extensive distribution was in the age group of 11–17 years (53.33%), sex proportions were equal both male (50%) and female (50%), all subjects have an atopic family history (100%). The mean vitamin D level was 18,02 ± 4,56 ng/ ml (deficiency), and the mean SCORAD score was 20,03 ± 5,80 (mild). There was a significantly strong negative correlation between low serum vitamin D level and severity of AD in children (r = -0.666, p = 0.001). 

Conclusion: Lower vitamin D status is inversely associated with the severity of AD in children.

 

References

Simpson EL, Leung DYM, Eichenfield LF, Boguniewicz M. Atopic Dermatitis. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, Orringer JS, editors. Fitzpatrick's dermatology in general medicine. 9th ed. New York: McGraw Hill Education; 2019. p. 363-81.

Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Lancet. 1998;351:1225–1232.

Nutten S. Atopic Dermatitis: Global Epidemiology and Risk Factors. Ann Nutr Metab. 2015; 66 (1): 8-16.

Umar M, Sastry KS, Ali FA, Al-Khulaifi M, Wang E, Chouchane AI. Vitamin D and pathophysiology of inflammatory skin diseases. Skin Pharmacol Physiol. 2018;31:74–86. DOI: 10.1159/000485132

Eichenfield LF, Tom WL, Berger TG, et al. Guidelines of care for the management of atopic dermatitis: Section 2. Management and treatment of atopic dermatitis with topical therapies. J Am Acad Dermatol. 2014;71(1):116-132.

Prietl B, Treiber G, Pieber TR, Amrein K. Vitamin D and immune function. Nutrients. 2013 Jul 5;5(7):2502-21. doi: 10.3390/nu5072502.

Schauber J, Gallo RL. Antimicrobial peptides and the skin immune defense system. J Allergy Clin Immunol. 2008;122(2):261-266.

Wang SS, Hon KL, Kong APS, Pong HNH, Wong GWK, Leung TF. Vitamin D deficiency is associated with diagnosis and severity of childhood atopic dermatitis. Pediatr Allergy Immunol. 2014;25(1):30‐35

Holick MF. Photobiology of Vitamin D. Biochemistry, Physiology and Diagnostics. 4th ed. Vol 1. 2018; 45-55.

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

Kunz B, Oranje AP, Labreze L, Stalder JF, Ring J, Taieb A. Clinical validation and guidelines for the SCORAD index: consensus report of the European Task Force on Atopic Dermatitis. Dermatology. 1997;195(1):10-19.

Akan A, Azkur D, Ginis T, et al. Vitamin D level in children is correlated with severity of atopic dermatitis but only in patients with allergic sensitizations. Pediatr Dermatol. 2013;30(3):359‐363.

Halim A, Munasir Z, Rohsiswatmo R. Manfaat Pemberian ASI Eksklusif dalam Pencegahan Kejadian Dermatitis Atopi pada Anak. Sari Pediatri. 2014;15(6):345-352 (13)

Moore MM, Rifas-Shiman SL, Rich-Edwards JW, Kleinman KP, Camargo CA, Gold DR, Weiss ST, Gillman MW. Perinatal predictors of atopic dermatitis occurring in the first six months of life. Pediatrics. 2004 Mar 1;113(3):468-74.

Budiastuti M, Wandita S, Sumandiono. Exclusive Breastfeeding and Risk of Atopic Dermatitis in High Risk Infant. Berkala Ilmu Kedokteran. 2007;39(4):192-198.

Baek JH, Jung IH, Kim HY, et al. The link between serum vitamin D level sensitisation to food allergens and the severity of atopic dermatitis in infancy. J Pediatr. 2014;165:849‐854.

D'Auria E, Barberi S, Cerri A, et al. Vitamin D status and body mass index in children with atopic dermatitis: a pilot study in Italian children. Immunol Lett. 2017;181:31‐35.

Farajzadeh S, Reghabatpour L, Aflatoonian M, Mohammadi S, Amiri R. Assessment of serum level of 25‐hydroxyvitamin D in Iranian children with atopic dermatitis, in Kerman city, an area with high sun exposure. JPAD. 2015;25(2):96‐100.

Galli E, Rocchi L, Carello R, Giampietro PG, Panei P, Meglio P. Serum Vitamin D levels and Vitamin D supplementation do not correlate with the severity of chronic eczema in children. Eur Ann Allergy Clin Immunol. 2015;47(2):41‐47.

Nwaru BI, Ahonen S, Kaila M, Erkkola M, Haapala AM, KronbergKippila C, et al. Maternal diet during pregnancy and allergic sensitization in the offspring by 5 yrs of age: a prospective cohort study. Pediatr Allergy Immunol. 2010;21:29-37.

Kim SW, Sung SM. Correlation between serum 25‐hydroxyvitamin D levels and severity of atopic dermatitis in pediatrics. Allergy. 2013;68:439.

Hovsepian S, Amini M, Aminorroaya A, Amini P, Iraj B. Prevalence of Vitamin D Deficiency among Adult Population of Isfahan City, Iran. J Health Popul Nutr [internet]. 2011;29(2):149-55. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21608424

Muehleisen B, Gallo RL. Vitamin D in allergic disease: shedding light on a complex problem. J Allergy Clin Immunol. 2013;131:324-9.

Cheon BR, Shin JE, Kim YJ. Relationship between serum 25-hydroxyvitamin D and interleukin-31 levels, and the severity of atopic dermatitis in children. Korean J Pediatr. 2015;58(3):96–101.

Thomsen SF. Atopic Dermatitis: Natural History, Diagnosis, and Treatment. Hindawi Publishing- ISRN allergy. 2014:1–7. Available from: http://dx.doi.org/10.1155/2014/354250

Kim SW, Sung SM. Correlation between serum 25‐hydroxyvitamin D levels and severity of atopic dermatitis in pediatrics. Allergy. 2013;68:439.

Galli E, Rocchi L, Carello R, Giampietro PG, Panei P, Meglio P. Serum Vitamin D levels and Vitamin D supplementation do not correlate with the severity of chronic eczema in children. Eur Ann Allergy Clin Immunol. 2015;47(2):41‐47.

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;69:40-6.

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):283‐288.68

Nutten S. Atopic Dermatitis: Global Epidemiology and Risk Factors. Ann Nutr Metab. 2015;66(1):8-16.

Penna G, Adorini L. 1 Alpha,25-dihydroxyvitamin D3 inhibits differentiation, maturation, activation, and survival of dendritic cells leading to impaired alloreactive T cell activation. J. Immunol. 2000;164(5):2405–2411.

Piemonti L, Monti P, Sironi M et al. Vitamin D3 affects differentiation, maturation, and function of human monocyte-derived dendritic cells. J. Immunol. 2000;164(9):4443–4451.

Pyun BY. Natural History and Risk Factors of Atopic Dermatitis in Children. Allergy Asthma Immunol Res. 2015;7(2):101-105.

Piotrowska A, Wierzbicka J, dan Zmijewski A. Vitamin D in the Skin Physiology and Pathology. Acta Biochimica Polonica. 2016; 63 (1): 17-29.

Manousaki D, Paternoster L, Standi M, Moffatt MF, et al. Vitamin D Levels and Susceptibility to Asthma, Elevated Immunoglobulin E. Levels, and Atopic Dermatitis: a Mendelian Randomization Study. Plos Med. 2017; 14 (5): 1-16.


Article Views      : 0
PDF Downloads : 0