Journal of Cutaneous Medicine and Surgery
1–4
© The Author(s) 2015
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DOI: 10.1177/1203475415622207
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Introduction
Psoriasis is a chronic inflammatory disease mediated by the
innate and acquired immune systems (T lymphocytes).
1
There
is evidence that vitamin D has immunomodulatory actions by
enhancing innate immune system function and modulating
the adaptive immune system. It induces production of cathe-
licidin in keratinocytes, inhibits the development of T helper
1 cells, induces T helper 2 cell pathways, induces B cell apop-
tosis, inhibits B cell maturation, and produces T regulatory
cells by dendritic cells.
2-4
Previous studies have proposed the
role of vitamin D deficiency in some autoimmune diseases,
such as multiple sclerosis, rheumatoid arthritis, systemic
lupus erythematous, and Crohn’s disease.
4,5
Vitamin D also
directly regulates the proliferation and growth of keratino-
cytes via vitamin D receptors.
6
There are several pathways for
the effect of vitamin D deficiency in psoriasis pathogenesis:
loss of antiproliferative, anti-inflammatory, and antiangio-
genic activities.
7
Psoriasis is an autoimmune disease medi-
ated by T helper 1 and T helper 17 pathways. Several studies
have shown the efficacy of narrow-band ultraviolet B
(NB-UVB) in parallel with elevation of serum vitamin D in
the treatment of plaque psoriasis, which has improved
researchers’ opinions regarding the effect of systemic vitamin
D on psoriasis.
8-13
Another study showed that baseline levels
of CYP27A1 and CYP27B1 enzymes (involved in vitamin D
metabolism) in skin biopsies of psoriatic lesions were lower
than those in normal skin from healthy people.
12
Given this evidence, there may be a role for vitamin D in the
pathogenesis of psoriasis. Gisondi et al,
14
Orgaz-Molina et al,
15
and Gutte and Pahuja
16
have shown vitamin D deficiency to be
more prevalent in patients with psoriasis than healthy individu-
als in Italy, Spain, and India, respectively. In this study, we
aimed to evaluate serum vitamin D levels of psoriatic patients
and compare them with levels in healthy controls.
Article
622207CMS XX X 10.1177/1203475415622207Journal of Cutaneous Medicine and SurgeryMaleki et al
research-article 2015
1
Cutaneous Leishmaniasis Research Centre, Department of Dermatology,
School of Medicine, Mashhad University of Medical Sciences, Mashhad,
Iran
2
Cutaneous Leishmaniasis Research Centre, Department of Pathology,
Mashhad University of Medical Sciences, Mashhad, Iran
3
Department of Biostatistics and Epidemiology, Mashhad University of
Medical Sciences, Mashhad, Iran
Corresponding Author:
Yalda Nahidi, Cutaneous Leishmaniasis Research Centre, Department
of Dermatology, Imam Reza Hospital, Mashhad University of Medical
Sciences, Mashhad, Iran
Email: nahidiy@mums.ac.ir
Serum 25-OH Vitamin D Level in
Psoriatic Patients and Comparison With
Control Subjects
Masoud Maleki
1
, Yalda Nahidi
1
, Sahar Azizahari
1
,
Naser Tayyebi Meibodi
2
, and Ali Hadianfar
3
Abstract
Background: Vitamin D has been shown to have immunomodulatory effects, and previous studies have proposed a role of
vitamin D deficiency in multiple autoimmune diseases, including psoriasis.
Objectives: The aim of this study was to investigate serum vitamin D levels in psoriatic patients and compare them with
levels in controls.
Methods: This study was carried out in 50 psoriasis patients. Serum vitamin D was measured by enzyme-linked immunosorbent
assay.
Results: The mean serum vitamin D levels in psoriatic patients and controls were 14.92 ± 6.31 and 12.52 ± 4.54 ng/mL,
respectively. The difference was not statistically significant (P = .06). The prevalence of vitamin D deficiency (<20 ng/mL) was
84.0% in psoriatic patients and 93.0% in controls (P = .21).
Conclusions: Most of the patients with psoriasis had vitamin D deficiency, which may have contributed to the evolution of
their psoriasis. However, considering the high prevalence of vitamin D deficiency in Iran, no difference was noted between
the psoriatic patients and the controls.
Keywords
psoriasis, serum vitamin D, Psoriasis Area and Severity Index (PASI)