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Information on the latest vitamin D news and research.

Find out more information on deficiency, supplementation, sun exposure, and how vitamin D relates to your health.

Case report: Vitamin D deficiency, atopic dermatitis and rickets

Researchers from Pontificia Universidad Católica de Chile in Santiago, Chile, recently reported on an interesting case from their hospital in the journal Pediatrics.

The doctors reported on a 14-year old girl with severe atopic dermatitis. Atopic dermatitis (AD) is a chronic and relapsing inflammatory skin condition, with symptoms like dry itchy skin and hyperresponsiveness to allergens. It affects 10 to 20% of children worldwide.

In this case, the girl had a history of AD since early childhood. When she presented to the doctors, eczema (inflammation of the skin) covered most of her skin. She had a history of poor response to corticosteroids, a typical treatment in AD.

The girl also reported muscular weakness and difficulty walking, but she did not claim to have any bone pain.

She had type IV skin (moderate brown), lived 41 degrees south of the equator in Chile and avoided direct sun exposure since early childhood because of her skin condition. Due to these factors, the researchers suspected she might have vitamin D deficiency.

What they found is that she had severe vitamin D deficiency. When they measured her vitamin D, she had an undetectable level of less than 5 ng/ml.

Due to reported troubles of walking and vague muscle weakness, coupled with this severe vitamin D deficiency, the doctors suspected rickets/osteomalacia.

When they examined markers for rickets, her alkaline phosphatase was 932 U/L (normal range 50-162 U/L) and radiographs of her wrist showed marginal sclerosis, suggesting bone mineralization abnormalities.

So they diagnosed hypocalcemic rickets and administered a dose 150,000 IU of vitamin D, followed by a 10,000 IU/week dose thereafter for 6 months. After 6 months, her vitamin D level rose to 17.6 ng/ml, still low but much better than 6 months prior.

As expected, the rickets resolved.

To the doctors’ surprise, however, is that the girl’s AD also improved significantly on the vitamin D regimen. To quantify the severity of AD, doctors use a scale called the SCORAD, which ranges from 0 (no AD) to 103 (most severe AD). In the 6 months on the vitamin D regimen, the girl’s SCORAD dropped from the mid-60s to just below 20, a threefold decrease in AD severity.

To date, research has shown a relationship between vitamin D deficiency and AD. Observational studies show that people with AD are more likely to have low vitamin D levels, and low vitamin D levels in AD predict an increased risk of skin infections. Some small pilot trials confirm that vitamin D might help in AD, too. However, we need more research to say for sure. Case reports like this one give hope that larger trials may prove vitamin D fairly effective in helping treat AD. It’s important to note the girl’s severe vitamin D deficiency may have left greater room for improvement in AD than normal.

The researchers also caution that clinicians need to suspect bone mineralization abnormalities in children and adults with similar conditions and circumstances. Here, the girl lived at a very high latitude, had darkish skin and avoided exposing her skin to the sun because she didn’t want to show her skin condition.

Source

Borzutzky, A., Grob, F., Camargo, C. a, & Martinez-Aguayo, A. (2014). Vitamin d deficiency rickets in an adolescent with severe atopic dermatitis. Pediatrics, 133(2).

  About: Brant Cebulla

Brant Cebulla was a staff member for the Vitamin D Council from May 2011 to April 2014. He has keen interests in nutrition and exercise.

7 Responses to Case report: Vitamin D deficiency, atopic dermatitis and rickets

  1. Michael says:

    Several years ago I told the story here of the great improvement in my son’s skin condition after starting 5000 Vitamin D. I also told the story of my one-on-one student recently arrived 4th grader from Kenya of Eritrean refugee status. He was fully, non-vocal except horrendous screaming, and wild, like a trapped animal. He screamed so much that I was allowed to keep him all day on the playground where he fell asleep every day at the bottom of the slide and slept for 40 minutes. I pulled his shirt up so he could get sun on his belly. He wore diapers and his face and butt were the same shade that first day. They moved us to a different bldg after 6 weeks and it also began to get cold. But by then he was a new person (by comparison to before). And he had just begun to speak. Of course, you guessed, I was let go by the idiot teacher who treated him “by the book”. That room fell apart as his condition worsened (I mean WILD animal) in the winter. The teacher was let go and that program was canceled and he was shipped elsewhere. Another failure for special ed and the already totally failed American public school system. A sad situation and tragedy for the boy and his mom. The boy who was almost saved by sunshine.

  2. Magic says:

    Americans are brainwashed…..And they do not like to be told that. I am old enough to remember the commercials from DOCTORS extolling the virtues of certain brands of cigarettes because they were especially good for you. Lots of people died in WWII. Lots more died in the next ten years because the free cigarettes got them hooked.

    Rita and I both try very hard to send people to this site. As the Annual Report shows, few showed up. I have many happy reports from people at the dog park who take D3 but not many who ever came here. They are getting good results without knowing the other vitamins that help with D3. People are just programmed by our media to die younger than they have to. Again IMO…..

  3. Rita and Misty says:

    <3 (Well, I can never remain silent for very long, can I?) 😉

    During 2013, visits to this website increased significantly; however, paid membership remained flat.

    This concerns me.

    There are 1480 members currently. If each of us brought in just one new member during 2014, we would be 2,960 strong.

    I think it is perilous to rely on simply the generosity of current donors. A nonprofit whose membership remains flat will not survive.

    We exist because we choose to belong—and to contribute.

    “Contribute” sometimes means more than dollars. It means effort. And effort just might mean outreach—to our friends and family and colleagues. To bring them here, as paid members.

    I apologize for my brazenly honest words.

    I love this website, as it is in my opinion such an excellent vehicle regarding up-to-date, unbiased information on Vitamin D.

    It would sadden me greatly if it no longer existed.

  4. Magic says:

    Rita,

    You know how I feel. It is amazing. People just don’t……….in everything…I belong to an Oregon football and other sport site. It costs about $120 a year. Half of it is free and I use that part of it 2/3 of the time. Still I have been paying for it about 15 years because I think the guy running it deserves to be paid. Today a guy was complaining because baseball was in the paid for group.

    Here we have something that everyone should know about and keep up with. Fifty bucks…..give me a break. You have always been conservative. I am always talking about the big hit. If 10,000 were paid members that would be better but only a piddling amount of people if it was only available in the ten mile radius of Yale.

    I don’t have pain. I don’t take prescription drugs. I feel great……….and I am still here ..I took statins from 1987 until 2003…Stopped, and wow I am still here… Maybe there is something to taking care of oneself …

  5. Rita and Misty says:

    I think that the burden is lighter when shared equally. For example:

    Current membership:

    Feb 2014: 1,480

    Projected:

    Feb 2015: 2,960

    Feb 2016: 5,920

    Is it really so very difficult for each of us to bring in one new member per year? For goodness sake, give the new membership as a gift Some of those gifts might just carry over by themselves.

  6. Magic says:

    Rita,

    My point has always been. This website should be like the morning paper, read every day… Well, bad example, nobody under 50 reads the paper. Anyway……..The point is that people are brainwashed to think that the docs were always right like the cigarette commercials or prescribing d2 instead of d3. They should go to this site as soon as they get on their computer.

  7. Magic says:

    Just found a great way to get people on the site. The average person giggles when talking about their demise. Why???? But they do. On the other hand Mothers worry about their children. I just read what D3 does to prevent cavities. It seems to me that sending Mothers to this “fabulous” website that covers a way of cutting cavities in Johnny or Susie in half or more. Think of the savings let alone the protection. Tell them that you are a member and it only costs $50 a year to belong and it is worth much more than that. Then they discover all of the other good stuff. Grandma has terrible arthritis, Uncle Larry is trying to stave off Alzheimers. etc.