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Home > Trending on TAP > June 2019 > Vitamins A and D in Atopic Dermatitis

Vitamins A and D in Atopic Dermatitis

6/25/2019 4:20:44 PM
atopic dermatitisAtopic dermatitis, characterized by recurrent eczematous skin lesions, has increased in recent years to affect between 10% and 20% of children worldwide. The pathophysiology of atopic dermatitis involves skin barrier dysfunction and abnormal immune responses—both of which are influenced by vitamins A and D.
 
Previous studies have suggested a role for vitamin D in the pathogenesis of atopic dermatitis because of its ability to regulate antimicrobial peptides, modulate immunity, and protect skin barrier function. Some studies have reported low serum vitamin D concentrations in patients with atopic dermatitis, but the association remains controversial.
 
Vitamin A also regulates immune function and skin integrity, but no previous studies have evaluated serum levels of vitamin A in children with atopic dermatitis. Also, no previous studies have explored whether there is a synergistic effect between vitamins A and D in children with atopic dermatitis.

New studies build upon older findings on vitamins D and A

A cross-sectional study, published in Dermatology in 2018, explored the associations between vitamin A deficiency, vitamin D deficiency, and severity of symptoms in children with atopic dermatitis. A total of 81 children with moderate or severe atopic dermatitis and healthy controls were enrolled in the study. The SCORing Atopic Dermatitis (SCORAD) index was used as a measurement of symptom severity and correlated with serum vitamin A, serum vitamin D, serum total immunoglobulin E (IgE), and peripheral blood eosinophil counts.

Levels of vitamins D and A lower in children with atopic dermatitis

Compared with healthy controls, the average serum vitamin D levels were significantly lower in children with atopic dermatitis (34.37 nmol/L vs. 50.70 nmol/L; p<.0001). Likewise, the average serum vitamin A levels were also significantly lower (0.87 micromols/L vs. 0.96 micromols/L; p=0.04).   
 
Serum levels of vitamin A and D were lower in children with severe symptoms than in those with moderate symptoms, and both vitamins negatively correlated with symptom severity (p<.001). Among the children with severe symptoms, 44% had vitamin D deficiency, 56% had vitamin D insufficiency, and none had adequate levels of vitamin D. There was a similar trend for vitamin A. Among children with severe symptoms, 33% had vitamin A deficiency, 50% had vitamin A insufficiency, and 17% had adequate levels of vitamin A. Symptom severity was worse in patients with both vitamin A and D co-deficiency. 
 
Peripheral blood eosinophil levels were significantly higher in children with atopic dermatitis than in healthy controls and were negatively correlated with vitamin A and D levels. Although serum IgE concentrations were also significantly higher in children with atopic dermatitis than in healthy controls, there was no correlation between vitamin levels and IgE.
 
In conclusion, this cross-sectional study reports that deficiencies of vitamin A and D are more prevalent in children with atopic dermatitis than in healthy controls, serum levels of vitamin A and D inversely correlate with symptom severity, and symptom severity is most extreme in children with vitamin A and D co-deficiency.
 
Reference
Xiang J, Wang H, Li T. Comorbidity of Vitamin A and Vitamin D Deficiency Exacerbates the Severity of Atopic Dermatitis in Children. Dermatology. 2019; 1-9.

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