Vitiligo - Stream

Around the 1% of the population of the United States: have common vitiligo (VV), a disorder of an autoimmune nature. As usual, vitiligo is associated with other immunopathogenic diseases, such as hypothyroidism and hyperthyroidism, diabetes and Sjögren's syndrome. Some autoimmune diseases, like rheumatoid arthritis, diabetes and multiple sclerosis, appear to be related to a vitamin D deficiency. Instead, little is known about the relationship between vitamin status and VV.

Vitamin D has many functions in the innate and acquired immune system.; in fact, B and T lymphocytes, dendritic cells and macrophages express receptors for vitamin D. further, Vitamin D analogues represent useful topical agents for the treatment of certain autoimmune skin conditions, such as psoriasis and VV. One study confirmed the effect of topical calcipotri in combination with corticosteroids in children with VV..

In this work, the authors discussed the possible link between vitamin D deficiency and VV.


Blood samples were collected from 45 subjects for determination of 25-hydroxyvitamin D levels (25 [OH] D). Patients provided information on the amount of dairy products and supplements consumed per day. Fifteen subjects reported an intake of approximately 200 IU of vitamin D y 30 consumed 100 UI or less. Daily vitamin D intake was not a significant predictor of serum levels or the presence of autoimmune diseases..

Demographic characteristics were considered, raza, background of vitiligo, daily vitamin D intake and personal and family history of autoimmune disorders. The skin phototype was considered according to the model proposed by Fitzpatrick and the affected body surface.. Single and multiple variable models were applied to determine the association between an insufficient concentration of 25 (OH) D (inferior a 30 of / ml), as well as age, sex, the ethnic origin, skin type, The time of year. vitamin was determined, disease onset, history of autoimmune disorders and affected body surface area. The relationship between very low levels of 25 (OH) D (below 15 of / ml) and the other variables. The odds ratio was calculated (OR) for all factors evaluated.



The study sample included 45 individuals aged between 2 Y 71 years (22,6 years on average), with all skin types. At 53%, vitamin D levels had been tested less than three months previously (recently diagnosed VV).

The 95,6% cases presented generalized deterioration: injury bilateral and symmetrical distribution characteristic sites: areas periorificiales, extensor surfaces of the limbs and on the joints. Lack of pigmentation was classified into three groups according to the affected skin surface: 1% a 5% of the area of ​​the body surface (ASC); 6% a 19% ASC and over the 20% ASC (57.8%, 20% Y 22.2%, respectively). Fifteen patients had one or more autoimmune disorders, including autoimmune thyroiditis and systemic lupus erythematosus. The 51% He reported a family history of autoimmune diseases.

The 62% determinations of vitamin D were conducted during the summer months. Serum concentrations of vitamins ranged from 7 Y 52 of / ml (23,5 of / ml on average), with a bimodal distribution: the first and the second peak were 18 of / ml y 31 of / ml, respectively.

According to the vitamin D, Three groups of patients were established: the 31,1% had normal values (above 30 of / ml); The 55,6% had insufficient vitamins (less than 30 of / ml) and the 13,3% I had very low levels, less than 15 of / ml. As there were no significant differences in the concentration of vitamins by month, all evaluations were analyzed together.

They have been associated very low levels of vitamin D (below 15 of / ml) with other autoimmune diseases (OR: 10.0), but not with skin phototype, age, sex, raza, station, family history of vitiligo or autoimmune disorders, recent illness and ASC. The data suggest that very low levels of 25 (OH) D (less than 15 of / ml) would identify patients at increased risk of other autoimmune diseases.

In subsequent models logistic regression, concomitant autoimmune diseases associated with very low concentrations of vitamin D (OR: 10) Y, Conversely, with a lower age (OR: 0.04); instead, They were not linked to insufficient vitamins (levels below 30 of / ml).

Partnerships with very low levels of 25 (OH) D and the inverse relationship with the younger age (1 a 9 years and 10 a 19 years) They persisted in the multivariate model: OR de 20.04, 0.06 for the group 1 a 9 years and 0.08 for the group 10 a 19 years. That is to say, the younger the patient, It is less likely to have other autoimmune disease.