WINTER RELATED ATOPIC DERMATITIS , VITAMIN D HELPS
A study conducted in
more than 100 Mongolian schoolchildren found that daily treatment with a
vitamin D supplement significantly reduced the symptoms of winter-related
atopic dermatitis, a type of eczema. Led by a Massachusetts General Hospital
(MGH) physician, the report in the October issue of the Journal of Allergy and Clinical
Immunology supports
the results of a preliminary study that showed similar results in a small group
of children in Boston
While we don't know
the exact proportion of patients with atopic dermatitis whose symptoms worsen
in the winter, the problem is common," says Carlos Camargo, MD, DrPH, MGH
Department of Emergency Medicine. "In this large group of patients, who probably
had low levels of vitamin D, taking daily vitamin D supplements -- which are
inexpensive, safe and widely available -- proved to be quite helpful."
Camargo led both the earlier Boston pilot study and the current investigation,
which was performed in collaboration with investigators from the Health
Sciences University of Mongolia.
A chronic inflammatory
disorder of the skin, atopic dermatitis is uncomfortable and makes patients
more vulnerable to bacterial infection. Symptoms of the disorder -- most commonly
seen in children -- often worsen during wintertime. While controlled
administration of ultraviolet light, which can stimulate the production of
vitamin D in the skin, is a common treatment for severe atopic dermatitis, the
possibility that vitamin D deficiency contributes to the seasonal worsening of
symptoms had received little consideration prior to the Boston study. That
investigation involved only 11 children but provided preliminary support for
the hypothesis.
The current study,
conducted in collaboration with the National Dermatology Center in Mongolia,
enrolled 107 children, ages 2 to 17, from nine outpatient clinics in the
capital city of Ulaanbaatar. The participants -- all of whom had a history of
atopic dermatitis symptoms worsening either during cold weather or around the
transition from autumn to winter -- were randomly divided into two groups. One
group received a daily vitamin D dose of 1000 IU while the other received a
placebo -- both delivered in odorless, colorless and tasteless drops. Neither
the children's parents nor the study investigators knew to which group
participants had been assigned.
Standard evaluations
of atopic dermatitis symptoms were conducted at the outset of the trial and at
the end of the month-long study period, and parents were also asked whether
they saw any improvement in their child's condition. At the end of the month,
children receiving the vitamin D supplement had an average 29 percent
improvement on the primary assessment tool used, compared with 16 percent improvement
in the placebo group. Additional assessments -- including the report from
parents -- also showed significantly greater improvement among children
receiving vitamin D.
While data gathered at
the outset of the study could not determine whether or not participating
children were deficient in vitamin D, the authors note that an even larger
study of Ulaanbaatar children conducted at the same time found significant
vitamin D deficiency in 98 percent of participants, supporting the probability
that the children in this study were also deficient. While future studies are
needed to assess the value of vitamin D treatment in adults and in children
with year-round symptoms, Camargo -- a professor of Medicine at Harvard Medical
School -- says that parents of children with symptoms that worsen in the winter
should try a vitamin D supplement for a few weeks when symptoms flare to see if
it helps. He encourages parents to discuss this study and their plan with their
primary care provider.
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