Serum 25-hydroxyvitamin D levels in patients with atopic eczema and the influence of narrow-band ultraviolet B phototherapy
Photodermatology, Photoimmunology & Photomedicine. doi: 10.1111/phpp.12117
R F Rose MRCP*, C Williams MRCP, T Oliphant MRCP, F Browne MRCP, D Turner, V Goulden FRCP, MD
Narrow-band ultraviolet B phototherapy (nbUVB) is an established treatment modality for patients with severe atopic dermatitis (AD) and is known to increase serum vitamin D levels (SVD). The relationship between SVD and AD remains unclear.
To assess SVD and disease severity in patients with AD before and after nbUVB and establish whether a change in SVD correlates to response to nbUVB.
A single-centre, open observational study recruited 21 male and 17 female patients with AD between November and April. Eczema severity was measured using the SCORAD tool and serum 25-hydroxyvitamin D3 levels were determined pre- and post- nbUVB which was administered thrice weekly.
9 patients had severe AD, 23 moderate and 6 mild indicated by SCORAD measurements. 17 patients completed the study. Median SVD increased from 45nmol/L pre-treatment to 169nmol/L post treatment (95% CI, 2.9 - 5.0 times baseline) (p<0.0001). Mean SCORAD reduction following nbUVB was significant at 21.9 units (95% CI, 14.9 - 28.9) (p<0.0001). No evidence of a relationship between change in SCORAD and change in SVD was found.
The number of patients failing to complete study.
Patients with AD are at risk of vitamin D deficiency. Correlation between this and disease severity has been postulated but this study does not provide confirmatory evidence.
Levels raised from 18 ng to 68 ng
Study duration = 6 months.
No indication of how long the people had useful vitamin D levels (> 40 ng)
only 45% of the people completed the study - no indication if the dropouts were or were not cured