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Spot Baldness (Alopecia Areata) associated with low vitamin D – many studies

See also VitaminDWiki


Alopecia Areata – Is vitamin D the only treatment? – meta-analysis April 2023

Biomarkers in alopecia Areata: A systematic review and meta-analysis
Autoimmun Rev. 2023 Apr 20;103339. doi: 10.1016/j.autrev.2023.103339
Hiba Zaaroura 1, Anthony J Gilding 2, Cathryn Sibbald 3

Background: Alopecia areata (AA) is an autoimmune non-scarring alopecia that affects the scalp or any hair-bearing areas in the body. The pathophysiology of AA is complex, but Th1, Th2, and Th17 cytokines dysregulation, as well as chemokines, immunoglobulins and other biomarkers have been shown to play a role in the pathogenesis of the disease.

Objective: To conduct a systematic review and Meta-analysis to identify biomarkers that reflect AA activity and severity that could be used to better assess disease activity and response in both trials and clinical practice.

Methods: A literature search was conducted using the PUBMED, EMBASE and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception to December 2021. Articles reporting on associations between AA and serum clinical biomarkers (cytokines, chemokines, antibodies, immunoglobulins, and others) were included. Serum biomarkers were identified in patients with AA and were correlated with disease severity and patient characteristics (ex. age, sex, comorbidities). The quality of the studies was assessed using the National Heart, Lung, and Blood Institute's Quality Assessment Tool for Case-Control Studies. Meta-analysis pooling of the standardized mean differences (SMD) by the method of Cohen using the common-effect inverse-variance model was performed. For the Meta-analysis, data was pulled for all the markers with a minimum of 4 studies with means and standard deviations. Analysis of data reported as Median with range or inter-quartile range (IQR) revealed that the data was too skewed to recommend calculation and use of mean with standard deviation (SD). If the data were not skewed, mean and SD were calculated.

Results: One thousand seven hundred fourteen studies were screened, with 91 included, reporting on a total of 52 biomarkers. Meta-analyses revealed pooled SMD that were significant for interleukin 6 (IL6), C-reactive protein (CRP) and vitamin D.

Conclusions: Serum IL6 and CRP levels are significantly increased in patients with AA compared to healthy age and sex matched controls. Conversely, serum vitamn D levels are significantly decreased in patients with AA compared to healthy age and sex matched controls. This data has the potenail to influence the clinical guidelines for the diagnostic workup of AA to include testing the serum levels of CRP and vitamin D.


Correlation of vitamin D and vitamin D receptor expression in patients with alopecia areata: a clinical paradigm - Dec 2017

Int J Dermatol. 2018 Feb;57(2):217-222. doi: 10.1111/ijd.13851. Epub 2017 Dec 15.
Daroach M1, Narang T1, Saikia UN2, Sachdeva N3, Sendhil Kumaran M1.

BACKGROUND: Vitamin D (Vit.D) deficiency has been reported in alopecia areata (AA). Downregulation of Vitamin D receptor (VDR) on hair follicles is associated with reduced hair growth.

OBJECTIVE: To correlate serum Vit.D levels with severity, pattern, and duration of AA, and density of VDR expression over hair follicles in AA patients.

METHODS: Prospective study including 30 AA patients and 30 healthy controls. Clinical details and serum Vit.D measurement and scalp biopsy for histopathology and VDR expression was performed in patients and controls at baseline and after 6 months of treatment of AA.

RESULTS:
Mean age of patients and controls was 28.9 ± 9.96 and 31.17 ± 9.43 years, respectively. Mean SALT score in patients was 35.8 ± 27.5 with a median disease duration of 48 weeks. Mean serum Vit.D levels was 7.65 ± 4.50 ng/ml and 15.8 ± 11.47 ng/ml in patients and controls, respectively. Twenty-nine (96.7%) patients were Vit.D deficient (<20 ng/ml), compared to 22 (73.3%) controls (P = 0.001). Serum Vit.D levels inversely correlated with severity of the disease (r = -256), P = 0.17, and duration of disease but did not correlate with pattern of AA and VDR expression in tissue samples. VDR expression was reduced in all patients and was normal in controls. Inverse correlation of VDR was noted with presence of inflammation on histology (P = 0.02). VDR upregulation post treatment was seen only in 13% of patients and demonstrated no correlation with response to treatment.

CONCLUSION:
Vit.D deficiency in AA correlates inversely with disease severity and duration. VDR expression is reduced in AA and inversely correlate with inflammation histologically but does not correlates with serum Vit.D levels, severity, pattern, or duration of illness.

PMID: 29243839 DOI: 10.1111/ijd.13851


Vitamin D Deficiency in Alopecia Areata- March 2014 (90% vs 33%)

Br J Dermatol. 2014 Mar 21. doi: 10.1111/bjd.12980.
Aksu Cerman A1, Sarikaya Solak S, Kivanc Altunay I.
Şişli Etfal Training and Research Hospital, Dermatology Department.

BACKGROUND: Alopecia areata is a T-cell mediated autoimmune disease that causes inflammation around anagen-stage hair follicles. Deficient vitamin D levels have been implicated in patients with a variety of autoimmune diseases in recent years. Previous reports have described the effects of vitamin D on hair follicles.

OBJECTIVES: The aim of the study was to evaluate the status of vitamin D in patients with alopecia areata and the relationship between vitamin D levels and disease severity.

METHODS: A cross-sectional study was conducted of 86 patients with alopecia areata, 44 patients with vitiligo, and 58 healthy controls. Serum vitamin D levels of the study group were determined by liquid chromatography/tandem mass spectrometry.

RESULTS:
Serum 25(OH)D levels in patients with alopecia areata were significantly lower than those of the patients with vitiligo and the healthy controls (P= 0.001 and P<0.001, respectively). The prevalence of 25(OH)D deficiency was significantly higher in the patients with alopecia areata (90.7%) compared with the patients with vitiligo (70.5%) and the healthy controls (32.8%) (P= 0.003 and P<0.001, respectively). Furthermore, a significant inverse correlation was found between disease severity and serum 25(OH)D level in the patients with alopecia areata (r= - 0.409; P<0.001).

CONCLUSION:
Deficient serum 25(OH)D levels are present in alopecia areata patients and inversely correlate with disease severity.
Accordingly, screening alopecia areata patients for vitamin D deficiency seems to be of value for the possibility of vitamin D supplementation.


Spot baldness strongly associated with low vitamin D levels – June 2014

Association between vitamin D levels and alopecia areata.
Isr Med Assoc J. 2014 Jun;16(6):367-70.
Mahamid M, Abu-Elhija O, Samamra M, Mahamid A, Nseir W.

BACKGROUND: Alopecia areata (AA) is an autoimmune disease, based on the response to local and/or systemic corticosteroid treatment. The role of vitamin D in the pathogenesis of immune/autoimmune mediated diseases has been widely studied.

OBJECTIVES: To investigate a possible association between serum 25-hydroxyvitamin D levels and alopecia areata.

METHODS: The study included 23 patients diagnosed with AA followed at our outpatient clinic during the period March 2010 to May 2011, as well as a control group matched for age and gender. All subjects underwent a complete work-up and medical examination, anthropometric measurements and laboratory tests. Laboratory tests included complete blood count, C-reactive protein (CRP), and vitamin D levels.

RESULTS: Mean CRP values were significantly higher in the AA group than the control group (1.1 +/- 0.7 mg/dl vs. 0.4 +/- 0.8 mg/ dl, P < 0.05). Vitamin D levels were significantly decreased in the AA group (11.32 +/- 10.18 ng/ml vs. 21.55 +/- 13.62 ng/ml in the control group, P < 0.05). Multivariate analysis showed that CRP (odds ratio 3.1, 95% confidence interval 2.6-4.2, P = 0.04) and serum vitamin D levels < 30 ng/ml (OR 2.3, 95% CI 2.2-3.1, P = 0.02) were associated with AA.

CONCLUSIONS: We found a significant correlation between AA and vitamin D deficiency.
Vitamin D deficiency can be a significant risk factor for AA occurrence.

PDF is attached at the bottom of this page

PMID: 25058999


AA had 13.5 ng, healthy controls had 22.5 ng. - April 2017


See also web

Reduced level of 25-hydroxyvitamin D in chronic/relapsing Alopecia Areata.

Dermatoendocrinol. 2013 Apr 1;5(2):271-3. doi: 10.4161/derm.24411. Epub 2013 Jan 1.
d'Ovidio R1, Vessio M, d'Ovidio FD.

Current observations link vitamin D deficiency to many autoimmune diseases. There are limited data on vitamin D in Alopecia Areata, an autoimmune disease which in our experience shows seasonality in most of its remitting-relapsing forms. Our results demonstrate the presence of insufficiency of 25-hydroxyvitamin D (25OH-D) in many patients with various clinical forms, correlated with the expected increase of the values of Parathyroid Hormone (PTH). This could suggest the possible clinical use of vitamin D in the management of this frustrating disease. PDF is online
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Reduced Alopecia scaring with higher levels of Vitamin D - April 2018

Vitamin D Status in Scarring and Non-Scarring Alopecia
Journal of the American Academy of Dermatology, https://doi.org/10.1016/j.jaad.2018.04.032
Rosalynn R.Z. Conic, MD1, 2, , , Melissa Piliang, MD1, Wilma Bergfeld, MD1, Natasha Atanaskova-Mesinkovska, MD PhD1, 3


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