Abstract
Objective: Approximately 9.4% of the world population is affected by acne during adolescence. Several previous studies have shown a significant relationship between acne vulgaris (AV) and serum vitamin D levels. The purpose of this study was to determine the correlation between AV and serum vitamin D levels in adolescents.
 Methods: This cross-sectional study included 60 healthy students with AV aged 15-18 y from three high schools in Depok, which were selected via simple random selection, and the selection of participants was based on consecutive sampling selection after screening with the inclusion criteria. Serum vitamin D levels were evaluated using a direct Chemiluminescence immunoassay (CLIA) method. The lesions of AV were counted by a dermatologist. Dietary vitamin D and fat intake were assessed using a semiquantitative Food Frequency Questionnaire and 24-hour dietary recall. The data were processed using SPSS Statistics 20.0 and analyzed using Pearson or Spearman correlation tests.
 Results: The mean serum vitamin D level was 17.29±6.77 ng/ml. The mean number of non-inflammatory lesions was 20.5±12.08, and the median number of inflammatory lesions was 6 (range 0-28). The correlation between the number of non-inflammatory lesion and serum vitamin D levels was r = 0.25 (p = 0.052) and the correlation between the number of inflammatory lesions and serum vitamin D levels was r = 0.047 (p = 0.72).
 Conclusion: Serum vitamin D levels are not significantly correlated with AV despite whether the lesions are inflammatory or non-inflammatory.
Highlights
Acne vulgaris (AV) is a chronic inflammation of the pilosebaceous unit; the cause is multifactorial with symptoms of blackheads, papules, cysts, and pustules [1]
Ghodsi et al stated that the prevalence of AV in adolescents who are exposed to AV is 85% and currently exceeds that of three major skin diseases in the community at large [2]
Vitamin D is a nutrient that is closely related to the skin because the skin is where vitamin D is synthesized through sun exposure
Summary
Acne vulgaris (AV) is a chronic inflammation of the pilosebaceous unit; the cause is multifactorial with symptoms of blackheads, papules, cysts, and pustules [1]. Ghodsi et al stated that the prevalence of AV in adolescents who are exposed to AV is 85% and currently exceeds that of three major skin diseases in the community at large [2]. AV occurs most often in early adolescence when sebum production begins. Vitamin D is a nutrient that is closely related to the skin because the skin is where vitamin D is synthesized through sun exposure. Vitamin D has important roles in the skin, such as differentiation and proliferation of sebocytes and keratinocytes, antimicrobial effects, natural immune and skin adaptive functions, regulation of the sebaceous glands, protection against light, and participation in wound healing [3]. Vitamin D deficiency often occurs in South Asia and Southeast Asia. The results of a study in Malaysia demonstrated more than half (580%) of adolescents had a serum vitamin D level (calcitriol)
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