Atopic Dermatitis and Eczema - many studies

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Atopic Dermatitis: 8 ng lower vitamin D - meta-analysis Aug 2022

Serum Vitamin D Level and Efficacy of Vitamin D Supplementation in Children with Atopic Dermatitis: A Systematic Review and Meta-analysis
Comput Math Methods Med . 2022 Jul 20;2022:9407888. doi: 10.1155/2022/9407888. eCollection 2022.
Hongbo Fu 1, Yanting Li 2, Huimin Huang 3, Dan Wang 3

Background: The relationship between vitamin D and atopic dermatitis (AD) is controversial. This meta-analysis is aimed at exploring vitamin D level and its deficiency in pediatric AD and at evaluating the efficacy of vitamin D supplementation.

Methods: PubMed, Medline, Embase, Ovid, Cochrane Library, ISI Web of Science, and ClinicalTrials were searched. Binary variables and continuous variables were measured by odds ratio (OR) and mean difference (MD) with 95% confidence intervals, respectively. The modified Jadad scale, Newcastle-Ottawa Scale (NOS), and Cochrane's bias risk tools were used to evaluate study quality and the risk of bias of eligible studies, respectively.

Results: A total of 22 literature were included in the analysis. Serum 25 (OH) D level in pediatric AD patients was significantly lower than that of the control group with a combined MD value of -8.18 (95% CI: -13.15, -3.22). Patients with AD were more prone to develop vitamin D deficiency with a combined OR value of 2.17 (95% CI: 1.15, 4.11). According to the score of SCORAD, the level of serum 25 (OH) D level in patients with severe AD was significantly lower than that in patients with mild AD (combined MD = 9.23, 95% CI: 6.92, 11.55). Both self-control studies and randomized controlled trials showed improved SCORAD score and EASI score after vitamin D supplementation.

Conclusion: This meta-analysis showed lower serum 25 (OH) D level and increased risk of vitamin D deficiency in pediatric AD patients as compared with healthy controls. The serum 25 (OH) D level in severe AD patients was significantly lower than that in the mild AD patients. The SCORAD and EASI score improved after vitamin D supplementation, suggesting its beneficial effect to AD patients. At the same time, more homogeneous studies are needed to reduce confounding factors and further evaluate the impact of vitamin D treatment on the outcome of AD patients.
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Atopic Dermatitis 5X more likely if low Vitamin D - Aug 2019

Dose–response association between vitamin D deficiency and atopic dermatitis in children, and effect modification by gender: a case-control study
Amal Ahmed Mohamed, Eman Mohamed Salah Ahmed, Youssef M. K. Farag, Nermeen Ibrahim BedairORCID Icon, Nourelhuda Ahmed Nassar & Ayat Ibrahim Mohamed Ghanem

Background: Vitamin D is a regulatory factor for immunity and skin barrier functions. It is hypothesized to be linked to atopic dermatitis (AD) which is characterized by interaction between epidermal barrier dysfunction and dysregulation of skin immune functions.

Methods: One hundred AD patients and one hundred and one normal controls were collected from outpatient clinic based on their clinical condition, both had measurement of 25-hydroxyvitamin D 25(OH)D. We assessed the relationship between 25(OH)D deficiency and AD prevalence using adjusted Poisson regression model.

Results: Serum 25(OH)D levels were significantly lower in cases than controls (mean 35.1 versus 22.6 ng/mL, p < .001). The unadjusted prevalence ratios (PRs) (95% CI) for AD for comparing participants with intermediate and deficient vitamin D levels to those with optimal levels were 3.11 (1.91, 5.06) and 4.77 (2.99, 7.60), respectively. The association did not materially change after adjusting for potential confounders. In the fully adjusted analysis stratified by gender, PRs for AD for comparing male participants with intermediate and deficient vitamin D levels to those with optimal levels were 3.38 (1.21, 9.40) and 5.20 (1.91, 14.13), respectively, whereas in the female participants were 1.32 (0.96, 1.83) and 1.49 (1.04, 2.14), respectively (p-interaction <.001).

Conclusion: In this case-control study in children, we found a statistically significant dose–response association between vitamin D deficiency and AD. We also observed a statistically significant effect modification of this association by gender. Further research is recommended to study this association longitudinally, and to examine whether treating vitamin D deficiency may potentially improve AD.

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Atopic Dermatitis: treated by Vitamin D – Review of Micronutrients – March 2019

Micronutrients in Atopic Dermatitis: A Systematic Review
J Altern Complement Med. 2019 Mar 26. doi: 10.1089/acm.2018.0363.
Vaughn AR1, Foolad N2, Maarouf M3, Tran KA3, Shi VY4.
1 Department of Dermatology, University of California-Davis, Sacramento, CA.
2 School of Medicine, University of California-Davis, Sacramento, CA.
3 College of Medicine, University of Arizona-Tucson, Tucson, AZ.
4 Division of Dermatology, Department of Medicine, University of Arizona-Tucson, Tucson, AZ.

OBJECTIVE:
The pathophysiology of atopic dermatitis (AD) involves a complex interplay between immune system dysfunction, genetics, and environmental factors. It is well known that nutritional status is essential to a proper functioning immune system, leading to a highly debated question regarding the role of dietary factors in the pathogenesis of AD. Food allergies and elimination diets have been broadly studied in atopy; however, less consideration has been given to how vitamins, minerals, and other micronutrients influence the risk for AD and severity of symptoms. This systematic review discusses evidence on how various micronutrients, including vitamins (C, E, and D) and trace minerals (zinc, selenium, iron, copper, magnesium, and strontium) are associated with AD, and how supplementation influence disease severity.

DESIGN:
A systematic search was conducted to identify the role that oral micronutrients have on AD. The authors reviewed 49 studies herein.

RESULTS:
While there are weak associations between vitamins C or E and AD, there is sufficient evidence to suggest that vitamin D supplementation provides benefit in AD patients. Deficiency of selenium and zinc may exacerbate AD. Current reports are not sufficient to confidently discern the role of other vitamins and trace minerals on AD.

CONCLUSIONS:
Though oral micronutrients may play a role in AD, the current literature is limited, and there is a need for more comprehensive randomized controlled trials (RCTs) to truly decipher the role between oral micronutrients and AD.

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Atopic dermatitis treatment needs more than 5,000 IU of Vitamin D – RCT Sept 2018

Oral vitamin D3 5000 IU/day as an adjuvant in the treatment of atopic dermatitis: a randomized control trial
Intenational Journal of Dermatology 20 September 2018 https://doi.org/10.1111/ijd.14220
Karen Sánchez‐Armendáriz MD Ana García‐Gil MD Cesar A. Romero MD José Contreras‐Ruiz MD Marcia Karam‐Orante MD

PDF is available free at Sci-Hub   10.1111/ijd.14220

Background:Vitamin D has immunomodulatory effects both in the innate and adaptive immune systems, and there is growing scientific evidence demonstrating its relevance in inflammatory processes such as AD.

Hypothesis: If vitamin D3 promotes the skin immune system, then it should improve the response to treatment of patients with AD.

Methods
A randomized, double‐blind placebo‐controlled clinical trial was conducted, which included 65 patients with AD according to Hanifin–Rajka criteria and the severity scale (SCORAD). The patients were divided into two groups to receive either vitamin D3 5000 IU/day (n = 33) or placebo (n = 32), plus baseline therapy (topical steroid, soap substitute, and emollient) during 3 months.

Results
Fifty‐eight of the 65 enrolled subjects were included in the analysis. At the end of the intervention, the treated group achieved higher levels of 25(OH)D (P < 0.001). At week 12, those patients who registered serum levels of 25(OH)D ≥20 ng/ml, regardless of whether or not they had received supplementation, showed a lower SCORAD compared to those with levels <20 ng/ml (P < 0.001). Eighty percent of the patients with serum levels <20 ng/ml (n = 9) had moderate–severe AD despite standard treatment. Vitamin D levels ≥20 ng/ml associated with baseline therapy strongly favored remission of atopic dermatitis (P = 0.03). No significant differences were found between patients with serum levels of ≥20 ng/ml vs. ≥30 ng/ml.

Conclusions: Reaching serum levels of 25(OH)D > 20 ng/ml in conjunction with standard therapy is sufficient to achieve a reduction in severity (SCORAD) in patients with AD.

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Atopic Dermatitis reduced by 5,000 IU of Vitamin D for 12 weeks – RCT Dec 2018

Oral vitamin D3 5000 IU/day as an adjuvant in the treatment of atopic dermatitis: a randomized control trial.
Int J Dermatol. 2018 Dec;57(12):1516-1520. doi: 10.1111/ijd.14220. Epub 2018 Sep 20.
Sánchez-Armendáriz K1, García-Gil A1, Romero CA2, Contreras-Ruiz J1, Karam-Orante M1, Balcazar-Antonio D3, Domínguez-Cherit J4.

BACKGROUND: Vitamin D has immunomodulatory effects both in the innate and adaptive immune systems, and there is growing scientific evidence demonstrating its relevance in inflammatory processes such as AD.

HYPOTHESIS: If vitamin D3 promotes the skin immune system, then it should improve the response to treatment of patients with AD.

METHODS:
A randomized, double-blind placebo-controlled clinical trial was conducted, which included 65 patients with AD according to Hanifin-Rajka criteria and the severity scale (SCORAD). The patients were divided into two groups to receive either vitamin D3 5000 IU/day (n = 33) or placebo (n = 32), plus baseline therapy (topical steroid, soap substitute, and emollient) during 3 months.

RESULTS:
Fifty-eight of the 65 enrolled subjects were included in the analysis. At the end of the intervention, the treated group achieved higher levels of 25(OH)D (P < 0.001). At week 12, those patients who registered serum levels of 25(OH)D ≥20 ng/ml, regardless of whether or not they had received supplementation, showed a lower SCORAD compared to those with levels <20 ng/ml (P < 0.001). Eighty percent of the patients with serum levels <20 ng/ml (n = 9) had moderate-severe AD despite standard treatment. Vitamin D levels ≥20 ng/ml associated with baseline therapy strongly favored remission of atopic dermatitis (P = 0.03). No significant differences were found between patients with serum levels of ≥20 ng/ml vs. ≥30 ng/ml.

CONCLUSIONS: Reaching serum levels of 25(OH)D > 20 ng/ml in conjunction with standard therapy is sufficient to achieve a reduction in severity (SCORAD) in patients with AD.

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Randomized controlled trial using vitamins E and D supplementation in atopic dermatitis - July 2011

J Dermatolog Treat. 2011 Jun;22(3):144-50. Epub 2010 Jul 24.
Javanbakht MH, Keshavarz SA, Djalali M, Siassi F, Eshraghian MR, Firooz A, Seirafi H, Ehsani AH, Chamari M, Mirshafiey A.
Department of Nutrition and Biochemistry, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

BACKGROUND: Atopic dermatitis is a chronically relapsing, highly pruritic and inflammatory skin disease. This study was done to assess the effects of vitamins D and E supplementation on the clinical manifestation of atopic dermatitis.

METHODS: Forty-five atopic dermatitis patients were included in a randomized, double-blind, placebo-controlled trial. They were randomly divided into four groups and treated for 60 days: group P (n = 11), vitamins D and E placebos; group D (n = 12), 1600 IU vitamin D(3) plus vitamin E placebo; group E (n = 11), 600 IU synthetic all-rac-?-tocopherol plus vitamin D placebo; and group DE (n = 11), 1600 IU vitamin D(3) plus 600 IU synthetic all-rac-?-tocopherol. Serum 25(OH) vitamin D and plasma ?-tocopherol were determined before and after the trial. The clinical improvement was evaluated with SCORing Atopic Dermatitis (SCORAD). Data were analyzed by analysis of variance (ANOVA) and Kruskal-Wallis tests.

RESULTS: SCORAD was reduced after 60 days in groups D, E and DE by 34.8%, 35.7% and 64.3%, respectively (p = 0.004). Objective SCORAD also showed significant improvement. There was a positive correlation between SCORAD and intensity, objective, subjective and extent (p < 0.001). We found a significant negative association between plasma ?-tocopherol and SCORAD, intensity, objective and extent (p = 0.02).

CONCLUSION: This study supports the contributing and beneficial effects of vitamins D and E in the treatment of atopic dermatitis.

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See also VitaminDWiki

• Overview Skin and vitamin D
• Childhood allergy, asthma and eczema associated with repeated low vitamin D tests – Oct 2016
• 35,000 IU vitamin D daily for 6 months helped ALL psoriasis suffers (106 ng) – Brazil March 2013

Intervention AND Skin in VitaminDWiki

Inflamation AND Skin in VitaminDWiki

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VitaminDWiki pages with ATOPIC or ECZEMA in title (16 as of May 2022)

This list is automatically updated

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What is the difference between atopic dermatitis and eczema?

MedicineNet
Eczema is used as a general term for many types of skin inflammation (dermatitis) and allergic-type skin rashes. There are different types of eczema, like allergic, contact, irritant, and nummular eczema. Several other forms have very similar symptoms. The diverse types of eczema are listed and briefly described below. Atopic dermatitis is typically a more specific set of three associated conditions occurring in the same person including eczema, allergies, and asthma. Not every component has to be present at the same time, but usually these patients are prone to all of these three related conditions.

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Types of eczema

• Contact eczema: a localized reaction that includes redness, itching, and burning where the skin has come into contact with an allergen (an allergy-causing substance) or with an irritant such as an irritating acid, a cleaning agent, or other chemical
• Allergic contact eczema: a red, itchy, weepy reaction where the skin has come into contact with a substance that the immune system recognizes as foreign, such as poison ivy or certain preservatives in creams and lotions like Neosporin or Bacitracin
• Seborrheic eczema (also called seborrheic dermatitis or seborrhea): is a very common form of mild skin inflammation of unknown cause that presents as yellowish, oily, scaly patches of skin on the scalp, face, ears, and occasionally other parts of the body. Often this is also called dandruff in adults or "cradle cap" in infants.
• Nummular eczema: coin-shaped (round), isolated patches of irritated skin — most commonly on the arms, back, buttocks, and lower legs — that may be crusted, scaling, and extremely itchy
• Neurodermatitis: a very particular type of dermatitis where the person frequently picks at their skin, causing rashes. The underling cause may be a sensitivity or irritation which sets off a cascade of repeated itching and scratching cycles. It may be seen as scratch marks and pick marks on the skin. Sometimes scaly patches of skin on the head, lower legs, wrists, or forearms caused by a localized itch (such as an insect bite) may become intensely irritated when scratched.
• Stasis dermatitis: a skin irritation on the lower legs, generally related to circulatory problems and congestion of the leg veins. It may have a darker pigmentation, light-brown, or purplish-red discoloration from the congestion and back up of the blood in the leg veins. It's sometimes seen more in legs with varicose veins.

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Seborrheic Dermatitis 4.2X more likely if <30 ng of Vitamin D - Feb 2021

Serum Levels of 25-Hydroxyvitamin D in Patients with Seborrheic Dermatitis: A Case-Control Study
Dermatol Res Pract . 2021 Feb 20;2021:6623271. doi: 10.1155/2021/6623271
Siavash Rahimi 1, Negar Nemati 1, Seyedeh Sareh Shafaei-Tonekaboni 1

Several autoimmune papulosquamous skin conditions such as psoriasis, systemic lupus erythematous, and lichen planus have been associated with vitamin D deficiency or correlated with serum vitamin D level. This study was aimed at comparing the 25-hydroxyvitamin D (25(OH)D) status in patients with facial or scalp seborrheic dermatitis with healthy subjects. This case-control study included 289 patients (118 with psoriasis and 171 sex- and age-matched control subjects) from the outpatient clinic of two hospital dermatology departments in the west of Mazandaran province, Iran. All patients and control subjects were studied during one season to avoid seasonal variations in vitamin D levels. Serum mean ± standard deviation of 25(OH)D levels were significantly lower in seborrheic dermatitis patients than in control subjects (20.71 ± 8.16 vs. 23.91 ± 7.78, P = 0.007).
Serum 25(OH)D levels were negatively associated with the risk of developing seborrheic dermatitis (odds ratio (OR): 0.898, 95% confidence interval (Cl): 0.840-0.960, P = 0.002).
Also, vitamin D under 30 ng/ml was associated with OR: 4.22 (95% Cl: 1.077-16.534, P = 0.039) for seborrheic dermatitis. The severity of scalp disease was significantly associated with serum 25(OH)D level (P = 0.003). Cases with severe scalp scores had significantly lower serum 25(OH)D level compared to moderate OR score (P = 0.036). A similar trend was not seen in the facial disease. The 25(OH)D values are significantly lower in seborrheic dermatitis patients than in healthy subjects. Furthermore, the scalp disease severity was associated with lower serum 25(OH)D level. Our results may suggest that vitamin D may play a role in the pathogenesis of seborrheic dermatitis.
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See also web

• Eczema and Dermatitis Everwell - overview, probably nothing about Vitamin D
• Pubmed query "atopic dermatitis." "vitamin d" 263 items March 2019
• Atopic Dermatitis ==> Osteopenia 1.8 X
• Correlation of Vitamin D3 Levels and SCORAD Index in Atopic Dermatits: A Case Control Study. Julu 2017
  The worse the AD, the lower the Level of vitamin D. (nmol/L) free PDF online
  None (controls) = 53, Mild = 33, Moderate = 31.5, Severe = 21
• Change in the prevalence of Eczema since the 2nd World War UK published 2012: has the following chart

Typical Eczema sites on body, scratching - images from web

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