Role of Vitamin D in the Treatment of Atopic Dermatitis

Claudia Felicia Limanda; Gabriella Gabriella; Elvira Bernadetta; Jackson Hakim; Verika Christabela Tansuri

doi:10.37287/ijghr.v6i4.3195

Claudia Felicia Limanda Faculty of Medicine, Udayana University
Gabriella Gabriella Faculty of Medicine, Atma Jaya University
Elvira Bernadetta Faculty of Medicine, Indonesian Methodist University
Jackson Hakim Faculty of Medicine, North Sumatra University
Verika Christabela Tansuri Faculty of Medicine, Pelita Harapan University

DOI: https://doi.org/10.37287/ijghr.v6i4.3195

Keywords: atopic dermatitis, calciferol, calcitriol, vitamin D

Abstract

Atopic dermatitis (AD) is a chronic and recurrent inflammatory condition that affects patients' quality of life. One alternative that has an anti-inflammatory effect on AD is vitamin D (25-hydroxyvitamin D (25(OH)D). Although the main treatment for AD uses drugs such as corticosteroids or immunosuppressants, the side effects caused are quite high. Therefore, the aim of this review This literature aims to find out more about the effectiveness of vitamin D against AD, so that it can be an alternative treatment option. Objective: To determine the role of vitamin D in the treatment of atopic dermatitis. Method: The research took database sources from Pubmed, Google Scholar, Science Direct, and Cochrane from 2014-2023 which were then selected based on the inclusion and exclusion criteria that had been created. A total of 17972 articles were found using the keywords ("Vitamin D" OR "Calciferol" OR "Calcitriol") AND "Atopic Dermatitis" AND ("Role" OR "Function") which then after screening, 16 articles were taken for this literature review. Results: AD is an inflammatory condition that is influenced by various factors. The severity of this disease can be assessed using SCORAD or EASI. AD patients generally have lower serum vitamin D levels and decreased SCORAD index. However, vitamin D supplementation in AD treatment varies according to each country and geographic region. Conclusions: Various studies have been conducted to review the effects of vitamin D supplementation on AD, but not all of them show significant effects. This is influenced by many factors, especially age, dosage, preparation, country and geographical area. So more in-depth research is needed on this matter.

References

Multistrain synbiotic and vitamin D3 supplements on the severity of atopic dermatitis among infants under 1 year of age: a double-blind, randomized clinical trial study. J Dermatolog Treat, 33(2), 812-7.

Bothou, C., Alexopoulos, A., Dermitzaki, E., Kleanthous, K., Papadimitriou, A., Mastorakos, G., Papadimitriou, D. T. (2018). Successful Treatment of Severe Atopic Dermatitis with Calcitriol and Paricalcitol in an 8-Year-Old Girl. Case Rep Pediatr, 2018, 9643543. doi: 10.1155/2018/9643543. PMID: 30034905; PMCID: PMC6035840.

Camargo, C. A., Ganmaa, D., Sidbury, R., Erdenedelger, K., Radnaakhand, N., Khandsuren, B. (2014). Randomized trial of vitamin D supplementation for winter-related atopic dermatitis in children. J Allergy Clin Immunol, 134(4), 831-835.e1. http://dx.doi.org/10.1016/j.jaci.2014.08.002

Crichton, M. L., Nicholas, C., Purcell, S. (2021). The Eczema Area and Severity Index—A Practical Guide. J Aesthetic Nurs, 10(4), 174-179. doi:10.12968/joan.2021.10.4.174.

Di Filippo, P., Scaparrotta, A., Rapino, D., Cingolani, A., Attanasi, M., Petrosino, M. I., Chuang, K., Di Pillo, S., Chiarelli, F. (2015). Vitamin D Supplementation Modulates the Immune System and Improves Atopic Dermatitis in Children. International Archives of Allergy and Immunology, 166, 91 - 96.

Dogru, M. (2018). Is vitamin D level associated with the natural course of atopic dermatitis? Allergol Immunopathol (Madr), 46(6), 546–51. https://doi.org/10.1016/j.aller.2017.12.004

D’Auria, E., Barberi, S., Cerri, A., Boccardi, D., Turati, F., Sortino, S., Banderali, G., Ciprandi, G. (2017). Vitamin D status and body mass index in children with atopic dermatitis: A pilot study in Italian children. Immunol Lett, 181, 31–5. http://dx.doi.org/10.1016/j.imlet.2016.11.004

Eichenfield, L. F., Tom, W. L., Berger, T. G., Krol, A., Paller, A. S., Schwarzenberger, K., Bergman, J. N., Chamlin, S. L., Cohen, D. E., Cooper, K. D., Cordoro, K. M., Davis, D. M., Feldman, S. R., Hanifin, J. M., Margolis, D. J., Silverman, R. A., Simpson, E. L., Williams, H. C., Elmets, C. A., Block, J., Harrod, C. G., Begolka W. S., Sidbury, R. (2014). Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies. J Am Acad Dermatol, 71(1), 116-32. doi: 10.1016/j.jaad.2014.03.023.

Flohr, C., Mann, J. (2014). New insights into the epidemiology of childhood atopic dermatitis. Allergy, 69(1), 3-16.

Fu, H., Li, Y., Huang, H., Wang, D. (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. https://doi.org/10.1155/2022/9407888

Ghanem, B. M., Salem, H. A., Marzouk, H. F., Ismail, A. E. Y. (2017). Serum Vitamin D level in Egyptian children with atopic dermatitis and efficacy of Vitamin D supplementation. J Egypt Women’s Dermatologic Soc, 14(3), 190–6. http://dx.doi.org/10.1097/01.EWX.0000516170.33041.a5

Gittler, J. K., Shemer, A., Suárez-Fariñas, M., Fuentes-Duculan, J., Gulewicz, K. J., Wang, C. Q., Mitsui, H., Cardinale, I., de Guzman Strong, C., Krueger, J. G., Guttman-Yassky, E. (2012). Progressive activation of T(H)2/T(H)22 cytokines and selective epidermal proteins characterizes acute and chronic atopic dermatitis. J Allergy Clin Immunol, 130(6), 1344-54. doi: 10.1016/j.jaci.2012.07.012.

Hanifin, J. M., Baghoomian, W., Grinich, E., Leshem, Y. A., Jacobson, M., Simpson, E. L. (2022). The Eczema Area and Severity Index-A Practical Guide. Dermat contact, atopic, Occup drug, 33(3), 187–92. https://doi.org/10.1097/der.0000000000000895

Hata, T. R., Audish, D., Kotol, P., Coda, A., Kabigting, F., Miller, J., Alexandrescu, D., Boguniewicz, M., Taylor, P., Aertker, L., Kesler, K., Hanifin, J. M., Leung, D. Y., Gallo, R. L. (2014). A randomized controlled double-blind investigation of the effects of vitamin D dietary supplementation in subjects with atopic dermatitis. J Eur Acad Dermatol Venereol, 28(6), 781-9. doi: 10.1111/jdv.12176.

Hattangdi-Haridas, S. R., Lanham-New, S. A., Wong, W. H. S., Ho, M. H. K., Darling, A. L. (2019). Vitamin D Deficiency and Effects of Vitamin D Supplementation on Disease Severity in Patients with Atopic Dermatitis: A Systematic Review and Meta-Analysis in Adults and Children. Nutrients, 11(8), 1854. doi: 10.3390/nu11081854.

Kim, G., Bae, J. H. (2016). Vitamin D and atopic dermatitis: A systematic review and meta-analysis. Nutrition, 32(9), 913-920.

Kim, J. E., Kim, H. J., Lew, B. L., Lee, K. H., Hong, S.P. (2016). The severity of atopic dermatitis evaluated with the SCORAD index and the occurrence of bronchial asthma and rhinitis, and the duration of atopic dermatitis. Allergy, Asthma & Immunology Research, 8(4), 353-358. doi:10.4168/aair.2016.8.4.353.

Kim, M. J., Kim, S. N., Lee, Y. W., Choe, Y. B., Ahn, K. J. (2016). Vitamin D Status and Efficacy of Vitamin D Supplementation in Atopic Dermatitis: A Systematic Review and Meta-Analysis. Nutrients, 8(12), 789. doi: 10.3390/nu8120789.

Lara-Corrales, I., Huang, C. M., Parkin, P. C., Rubio-Gomez, G. A., Posso-De Los Rios, C. J., Maguire, J., Pope, E. (2019). Vitamin D Level and Supplementation in Pediatric Atopic Dermatitis: A Randomized Controlled Trial. J Cutan Med Surg, 23(1), 44-49. doi: 10.1177/1203475418805744.

Mansour, N. O., Mohamed, A. A., Hussein, M., Eldemiry, E., Daifalla, A., Hassanin, S., Nassar, N., Ghaith, D., Salah, E. M. (2020). The impact of vitamin D supplementation as an adjuvant therapy on clinical outcomes in patients with severe atopic dermatitis: A randomized controlled trial. Pharmacol Res Perspect, 8(6), e00679. doi: 10.1002/prp2.679.

Margolis, D. J., Apter, A. J., Gupta, J., Hoffstad, O., Papadopoulos, M., Campbell, L. E., Sandilands, A., McLean, W. H., Rebbeck, T. R., Mitra, N. (2012). The persistence of atopic dermatitis and filaggrin (FLG) mutations in a US longitudinal cohort. J Allergy Clin Immunol, 130(4), 912-7. doi: 10.1016/j.jaci.2012.07.008.

Mirzakhani, H., Al-Garawi, A., Weiss, S. T., Litonjua, A. A. (2015). Vitamin D and the development of allergic disease: How important is it? Clin Exp Allergy, 45(1), 114–25. https://doi.org/10.1111/cea.12430

Mutgi, K., Koo, J. (2012). Update on the Role of Systemic Vitamin D in Atopic Dermatitis. Pediatric Dermatology, 30(3), 303–307. doi:10.1111/j.1525-1470.2012.01850.x

Oranje, A. P., Glazenburg, E. J., Wolkerstorfer, A., De Waard-Van Der Spek, F. B. (2007). Practical issues on interpretation of scoring atopic dermatitis: The SCORAD index, objective SCORAD and the three-item severity score. Br J Dermatol, 157(4), 645–8. https://doi.org/10.1111/j.13652133.2007.08112.x

O'Regan, G. M., Sandilands, A., McLean, W. H. I., Irvine, A. D. (2009). Filaggrin in atopic dermatitis. J Allergy Clin Immunol, 124(3 Suppl 2), R2-R6.

Park, J. S., Kim, M., Sol, I. S., Lee, K. S., Park, S., Yang, H. J., et al. (2023). Effect of Vitamin D on the Treatment of Atopic Dermatitis with Consideration of Heterogeneities: Meta-Analysis of Randomized Controlled Trials. Allergy, Asthma Immunol Res, 15(2), 262–70. https://doi.org/10.4168/aair.2023.15.2.262

Raj, K. A. P., Handa, S., Narang, T., Sachdeva, N., Mahajan, R. (2022). Correlation of serum vitamin D levels with severity of pediatric atopic dermatitis and the impact of vitamin D supplementation on treatment outcomes. J Dermatolog Treat, 33(3), 1397–400. http://dx.doi.org/10.1080/09546634.2020.1818677

Rosendahl, J., Pelkonen, A. S., Helve, O., Hauta-Alus, H., Holmlund-Suila, E., Valkama, S., Enlund-Cerullo, M., Viljakainen, H., Hytinantti, T., Mäkitie, O., Andersson, S., Mäkelä, M. J. (2019). High-Dose Vitamin D Supplementation Does Not Prevent Allergic Sensitization of Infants. J Pediatr, 209, 139-145.e1. doi: 10.1016/j.jpeds.2019.02.021.

Sánchez-Armendáriz, K., García-Gil, A., Romero, C. A., Contreras-Ruiz, J., Karam-Orante, M., Balcazar-Antonio, D., Domínguez-Cherit, J. (2018). Oral vitamin D3 5000 IU/day as an adjuvant in the treatment of atopic dermatitis: a randomized control trial. Int J Dermatol, 57(12), 1516-1520. doi: 10.1111/ijd.14220.

Severity Scoring of Atopic Dermatitis: The SCORAD Index. (1993). Consensus Report of the European Task Force on Atopic Dermatitis. Dermatology, 186(1), 23–31. https://doi.org/10.1159/000247298

Umehara, Y., Trujillo-Paez, J. V., Yue, H., Peng, G., Nguyen, H. L. T., Okumura, K., Ogawa, H., Niyonsaba, F. (2023). Calcitriol, an Active Form of Vitamin D3, Mitigates Skin Barrier Dysfunction in Atopic Dermatitis NC/Nga Mice. Int J Mol Sci, 24(11), 9347. doi: 10.3390/ijms24119347.

Vestita, M., Filoni, A., Congedo, M., Foti, C., Bonamonte, D. (2015). Vitamin D and atopic dermatitis in childhood. J Immunol Res, 257879. doi: 10.1155/2015/257879.

Weidinger, S., Beck, L. A., Bieber, T., Kabashima, K., Irvine, A. D. (2018). Atopic dermatitis. Nat Rev Dis Primers, 4(1):1.

Wollenberg, A., Barbarot, S., Bieber, T., Christen-Zaech, S., Deleuran, M., Fink-Wagner, A., Gieler, U., Girolomoni, G., Lau, S., Muraro, A., Czarnecka-Operacz, M., Schäfer, T., Schmid-Grendelmeier, P., Simon, D., Szalai, Z., Szepietowski, J. C., Taïeb, A., Torrelo, A., Werfel, T., Ring, J. (2019). Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I. J Eur Acad Dermatol Venereol, 33(7), 1436.