A pilot study assessing the role of 25 hydroxy vitamin D levels in patients with vitiligo vulgaris

Background: Very low vitamin D levels have been noted in patients with a variety of autoimmune diseases. Objective: To determine whether low vitamin D levels are associated with autoimmunity in the setting of vitiligo vulgaris. Methods: A prospective cohort study was conducted on 45 consecutive patients with vitiligo vulgaris. 25-Hydroxyvitamin D levels were determined from sera collected at the time of study enrollment. Logistic regression analysis of the relationship of 25-hydroxyvitamin D levels to disease state was performed, including surface area, recent-onset vitiligo; Fitzpatrick skin type and ethnicity, dairy intake, and both personal and family history of autoimmunity. Multiple univariate and multivariate logistic regression models were developed to assess the interrelationship of these parameters. Results: 25-Hydroxyvitamin D levels were divided into 3 groups: 31.1% were normal (>30 ng/ml,), 55.6% were insufficient (<30 ng/mL), and 13.3% were very low (<15 ng/ml). Insufficient 25-hydroxyvitamin D levels were associated with increasing Fitzpatrick phototypes (odds ratio [OR] = 1.76, 95% confidence interval [CI] = 1.12-2.77). Very low 25-hydroxvvitamin D levels were associated with comorbid autoimmune illness (OR = 10.00, 95% CI = 1.06-94.7), but not with age, gender, race/ethnicity, family history of vitiligo or autoimmune disease; new-onset disease, or body surface area affected. None of the surveyed patients reported daily vitamin D intake of greater than 200 IU. Limitations: This study consists of a small cohort that assesses point prevalence without assessing seasonal variation in vitamin D levels. Conclusions: Very low 25-hydroxyvitamin D levels (<15 ng/mL) appear to be a reasonable screening tool or the presence of comorbid autoimmunity. Furthermore, we demonstrate that Fitzpatrick phototype, rather than ethnicity, is specifically associated with 25-hydroxyvitamin D levels that are insufficient (<30 ng/mL). (J Am Acacl Dermatol 2010;62:937-41.)