Preliminary evidence for vitamin D deficiency in nodulocystic acne.

Mustafa Turgut Yildizgören,Arzu Karatas Togral

doi:10.4161/derm.29799

Abstract

Objective: Acne vulgaris is a chronic inflammatory disease, and hormonal influences, follicular plugging and follicular hyperkeratinization, increased sebum secretion, Propionibacterium acnes colonization, and inflammation are involved in its pathogenesis. Recently, a significant body of evidence has accumulated that describes the comedolytic properties of vitamin D and its roles as a modulator of the immune system, a regulator of the proliferation and differentiation of sebocytes and keratinocytes, and as an antioxidant. In this study, we aimed to compare serum vitamin D levels in a group of patients with nodulocystic acne with vitamin D levels in a group of control subjects to determine whether there was any relationship between the vitamin D and acne.Methods: Levels of 25-hydroxyvitamin D (25[OH]D) were measured in 43 patients with newly diagnosed nodulocystic acne and in 46 healthy control subjects, and participants were grouped according to their 25[OH]D levels as follows: normal/sufficient (>20 ng/mL) or insufficient/deficient (<20 ng/mL). Serum concentrations of calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), and parathyroid hormone (PTH) were measured.Results: Forty-three patients and 46 control individuals, with mean ages of 23.13 (± 5.78) years and 25.23 (± 4.73) years, respectively, were included in this study. There were no significant differences between the groups in relation to their body mass indices and Ca, P, ALP, and PTH levels. However, the patients with nodulocystic acne had significantly lower 25[OH]D levels than the subjects in the control group (P< 0.05).Conclusion: The patients with nodulocystic acne had relatively low serum vitamin D levels compared with the subjects in the control group. The findings from this study suggest that there is a connection between low vitamin D levels and acne. Larger epidemiologic studies are needed to confirm the status of vitamin D levels in patients with acne.

Highlights

Acne vulgaris (AV) is a common disorder of the pilosebaceous follicles that affects the skin of the face, neck, upper part of the trunk, and back
Many factors have been proposed that may underlie the pathogenesis of acne, including hormonal influences, follicular plugs and follicular hyperkeratinization, increased levels of sebum secretion, Propionibacterium acnes (P. acnes) colonization, and inflammation; recently, AV has been linked to the insulinotropic or “western diet” and increased mammalian target of rapamycin complex 1 signaling.[3,4,5]
There were no significant differences between the study groups in relation to age, body mass index (BMI), and sex distribution

Summary

Introduction

Acne vulgaris (AV) is a common disorder of the pilosebaceous follicles that affects the skin of the face, neck, upper part of the trunk, and back. Non-inflammatory and inflammatory acne lesions consist of open and/or closed comedones, papules, pustules, and nodules.[1] The onset of AV usually occurs during adolescence and during early adulthood.[2] Many factors have been proposed that may underlie the pathogenesis of acne, including hormonal influences, follicular plugs and follicular hyperkeratinization, increased levels of sebum secretion, Propionibacterium acnes (P. acnes) colonization, and inflammation; recently, AV has been linked to the insulinotropic or “western diet” and increased mammalian target of rapamycin complex 1 (mTORC1) signaling.[3,4,5]. Vitamin D regulates the immune system and the proliferation and differentiation of keratinocytes and sebocytes. It has antioxidant and anti-comedogenic properties.[6] a vitamin D deficiency may facilitate the pathogenesis of acne.

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Discussion

Conclusion