title: Randomized controlled trial using vitamins E and D supplementation in atopic dermatitis A randomized controlled double-blind investigation of the effects of vitamin D dietary supplementation in subjects with atopic dermatitis. Vitamin D supplementation in the treatment of atopic dermatitis: a clinical trial study. Evaluation of dietary intake of vitamin E in the treatment of atopic dermatitis: a study of the clinical course and evaluation of the immunoglobulin E serum levels. Consumption of organic foods and risk of atopic disease during the first 2 years of life in the Netherlands. Atopic dermatitis: clinical relevance of food hypersensitivity reactions. Does vitamin D intake during infancy promote the development of atopic allergy? Increased food allergy and vitamin D: randomized, double-blind, placebo-controlled trial. Randomized trial of vitamin D supplementation for winter-related atopic dermatitis in children.
abstract: Abstract Background : Atopic dermatitis is a chronically relapsing , highly pruritic and inflammatory skin disease . This study was done to assess the effects of vitamins D and E supplementation on the clinical manifestation of atopic dermatitis . Methods : Forty-five atopic dermatitis patients were included in a r and omized , double-blind , placebo-controlled trial . They were r and omly divided into four groups and treated for 60 days : group P ( n = 11 ) , vitamins D and E placebos ; group D ( n = 12 ) , 1600 IU vitamin D3 plus vitamin E placebo ; group E ( n = 11 ) , 600 IU synthetic all-rac-α-tocopherol plus vitamin D placebo ; and group DE ( n = 11 ) , 1600 IU vitamin D3 plus 600 IU synthetic all-rac-α-tocopherol .  Serum 25(OH ) vitamin D and plasma α-tocopherol were determined before and after the trial . The clinical improvement was evaluated with SCORing Atopic Dermatitis ( SCORAD ) . Data were analyzed by analysis of variance ( ANOVA ) and Kruskal-Wallis tests . Results : SCORAD was reduced after 60 days in groups D , E and DE by 34.8 % , 35.7 % and 64.3 % , respectively ( p = 0.004 ) . Objective SCORAD also showed significant improvement . There was a positive correlation between SCORAD and intensity , objective , subjective and extent ( p < 0.001 ) . We found a significant negative association between plasma α-tocopherol and SCORAD , intensity , objective and extent ( p = 0.02 ) . Conclusion : This study supports the contributing and beneficial effects of vitamins D and E in the treatment of atopic dermatitis BACKGROUND Subjects with atopic dermatitis ( AD ) have defects in antimicrobial peptide ( AMP ) production possibly contributing to an increased risk of infections . In laboratory models , vitamin D can alter innate immunity by increasing AMP production . OBJECTIVE To determine if AD severity correlates with baseline vitamin D levels , and to test whether supplementation with oral vitamin D alters AMP production in AD skin . METHODS This was a multi-centre , placebo-controlled , double-blind study in 30 subjects with AD , 30 non-atopic subjects , and 16 subjects with psoriasis . Subjects were r and omized to receive either 4000 IU of cholecalciferol or placebo for 21 days . At baseline and day 21 , levels of 25-hydroxyvitamin D ( 25OHD ) , cathelicidin , HBD-3 , IL-13 , and Eczema Area and Severity Index ( EASI ) and Rajka-Langel and scores were obtained . RESULTS At baseline , 20 % of AD subjects had serum 25OHD below 20 ng/mL. Low serum 25OHD correlated with increased Fitzpatrick Skin Type and elevated BMI , but not AD severity . After 21 days of oral cholecalciferol , mean serum 25OHD increased , but there was no significant change in skin cathelicidin , HBD-3 , IL-13 or EASI scores . CONCLUSIONS This study illustrated that darker skin types and elevated BMI are important risk factors for vitamin D deficiency in subjects with AD , and highlighted the possibility that seasonality and locale may be potent contributors to cathelicidin induction through their effect on steady state 25OHD levels . Given the molecular links between vitamin D and immune function , further study of vitamin D supplementation in subjects with AD is warranted BACKGROUND The role of vitamin D in Atopic Dermatitis ( AD ) is ambiguous and clinical trials are needed to assess the role of vitamin D in the treatment of AD . The aim of this clinical trial study to evaluate the effect of vitamin D supplementation on patients with AD . MATERIAL AND METHODS sixty AD patients were included in a r and omized , double-blind , placebo-controlled trial study . They were r and omly divided into two groups and treated for 60 days : group vitamin D ( n=30 ) , and placebo group ( n=30 ) . The two groups were as follows : Group D , 1600 IU cholecalciferol ( vitamin D ) and second group placebo . The severity of AD was evaluated based on SCORAD ( Scoring Atopic Dermatitis ) and TIS ( Three Item Severity score ) value by the same trained physician before and after the trial . RESULTS According to SCORAD and TIS value index in the vitamin D group showed significant improvement in patients with mild , moderate and severe AD ( P<0.05 ) and in patients who the intake placebo , this improvement did n't showed ( P>0.05 ) . CONCLUSION Results mention that supplementation with oral vitamin D dramatically improved disease severity in AD patients BACKGROUND Vitamin E ( VE ) is a potent antioxidant that can improve the immune macrophage-mediated response , decrease the production and /or release of prostagl and ins in humans , and decrease the serum levels of immunoglobulin E ( IgE ) in atopic subjects . AIM To compare the effects of placebo ( PL ) and VE intake ( 400 IU/day ) on subjective symptoms and serum IgE levels in 96 subjects with atopic dermatitis . MATERIAL S AND METHODS A single-blind clinical analysis was performed on 96 subjects r and omly divided into two groups . Fifty subjects were given orally 400 IU ( 268 mg ) of VE of natural origin , once a day for 8 months , and 46 took PL for the same period . Complete blood count , serum IgE levels , radioallergosorbent test ( RAST ) score , antinuclear antibodies ( ANA ) , and biochemical analysis were obtained at the time of enrollment and every 15 days during the 8 months of the study . To evaluate VE therapy , a question naire was sent to each subject for completion at the end of the study . RESULTS The results were as follows : ( A ) four subjects treated with VE worsened , compared to 36 in the PL group ; ( B ) six subjects in the VE group and five in the PL group showed no change ; ( C ) slight improvement was observed in 10 subjects in the VE group and four in the PL group ; ( D ) 23 of the 50 subjects treated with VE showed great improvement , compared to only one in the PL group ; and ( E ) there was almost complete remission of atopic dermatitis in seven of the 50 subjects in the VE group , but none in the PL group . Females showed less progression of atopic dermatitis than males in both groups and a higher percentage of almost complete remission ( five females and two males ) . The range of serum IgE levels varied markedly from 1005 to 490 IU/mL in the VE group and from 1239 to 812 IU/mL in the PL group over 8 months . Subjects with great improvement and near remission of atopic dermatitis in the VE group demonstrated a decrease of 62 % in serum IgE levels based on initial conditions , while , in subjects taking PL , the difference was approximately 34.4 % . No complications were observed in either group . A remarkable improvement in facial erythema , lichenification , and the presence of apparently normal skin was reported . Eczematous lesions healed mostly as a result of decreased pruritus . CONCLUSIONS The correlation between VE intake , IgE levels , and the clinical manifestations of atopy indicates that VE could be an excellent therapeutic tool for atopic dermatitis We prospect ively investigated whether organic food consumption by infants was associated with developing atopic manifestations in the first 2 years of life . The KOALA Birth Cohort Study in the Netherl and s ( n 2764 ) measured organic food consumption ,  eczema and wheeze in infants until age 2 years using repeated question naires . Diet was defined as conventional ( 90 % organic ) . Venous blood sample s taken from 815 infants at 2 years of age were analysed for total and specific IgE. Multivariate logistic regression models were fitted to control for potential confounding factors . Eczema was present in 32 % of infants , recurrent wheeze in 11 % and prolonged wheezing in 5 % . At 2 years of age , 27 % of children were sensitised against at least one allergen . Of all the children , 10 % had consumed a moderately organic diet and 6 % a strictly organic diet . Consumption of organic dairy products was associated with lower eczema risk ( OR 0.64 ( 95 % CI 0.44 , 0.93 ) ) , but there was no association of organic meat , fruit , vegetables or eggs , or the proportion of organic products within the total diet with the development of eczema , wheeze or atopic sensitisation . Further studies to substantiate these results are warranted Forty-six patients with atopic dermatitis ranging from mild to severe were evaluated for food hypersensitivity with double-blind placebo-controlled food challenges . Twenty-eight ( 61 % ) patients had a positive prick skin reaction to one of the foods tested . Sixty-five food challenges were performed ; 27 ( 42 % ) were interpreted as positive in 15 ( 33 % ) patients . Egg , milk , and peanut accounted for 78 % of the positive reactions . As in previous studies , patients developed skin ( 96 % ) , respiratory ( 52 % ) , or gastrointestinal ( 30 % ) symptoms during the challenge . These studies indicate that children who have atopic dermatitis unresponsive to routine therapy or who continue to need daily treatment after several months would benefit from evaluation for food hypersensitivity The active metabolite of vitamin D , 1,25-(OH)2D3 , has immunomodulatory properties in addition to its more established action on bone and calcium metabolism . Recently vitamin D has been proposed as one of several environmental factors responsible for the increase in atopic diseases during the last decades . The objective of this study was to determine whether the estimated dose of dietary vitamin D3 during the first year of life is associated with atopic diseases up to the age of 6 years . In a prospect i ve birth cohort study 123 six-year-old children were investigated for the cumulative incidence of atopic dermatitis , allergic rhinitis or asthma by means of a postal question naire . Their vitamin D3 intake during infancy was recorded in a previous study and the relationship between lower or higher vitamin D3 intake and atopic illness later in childhood was assessed . Atopic manifestations were more prevalent in the group with higher intake of vitamin D3 . Although small , this study supports previous investigations suggesting a role of vitamin D intake during infancy in the development of atopic allergy later in childhood . If these findings are confirmed in prospect i ve controlled clinical trials , prevention through modified vitamin D3 supplementation in infancy could be discussed to reduce the burden of atopic illnesses BACKGROUND To eluci date whether maternal vitamin D supplementation during lactation improves infantile eczema and other subsequent allergic disorders , a r and omized , double-blind , placebo-controlled trial was performed . METHODS Mothers ( n = 164 ) of infants with facial eczema at 1 month check-up were r and omly assigned to receive vitamin D3 supplements ( n = 82 ; 800 IU/day ) or placebo ( n = 82 ) for 6 weeks from May 2009 to January 2011 . The primary outcome was infantile eczema quantified on Scoring Atopic Dermatitis ( SCORAD ) index at 3 month check-up , and the secondary outcomes were atopic dermatitis , food allergy , and wheeze diagnosed by doctors up to 2 years of age . RESULTS There was no significant difference in SCORAD at 3 month check-up between the two groups . Doctor-diagnosed food allergy was significantly more common up to age 2 years in the vitamin D group ( 10/39 , 25.7 % ) than in the placebo group ( 3/40 , 7.5 % ; risk ratio ( RR ) , 3.42 ; 95 % confidence interval [ CI ] : 1.02 - 11.77 ; P = 0.030 ) . Moreover , at least one secondary outcome was also significantly more common in the vitamin D group ( 17/39 , 43.6 % ) than in the placebo group ( 7/40 , 17.5 % ; RR , 2.49 ; 95%CI : 1.16 - 5.34 ; P = 0.012 ) . CONCLUSIONS Vitamin D supplementation may not decrease the severity of infantile eczema at 3 months of age , but may rather increase the risk of later food allergy up to 2 years of age . Because a large number of subjects was lost to follow up , further study is needed to confirm the findings BACKGROUND Epidemiologic and pre clinical data , and a small r and omized trial in Boston , suggest that vitamin D supplementation may improve winter-related atopic dermatitis ( AD ) . OBJECTIVE To determine the effect of vitamin D supplementation on winter-related AD . METHODS We performed a r and omized , double-blind , placebo-controlled trial of Mongolian children with winter-related AD ( clinical trials.gov identifier : NCT00879424 ) . Baseline eligibility included age 2 to 17 years , AD score 10 to 72 using the Eczema Area and Severity Index ( EASI ) , and winter-related AD ( eg , history of AD worsening during the fall-to-winter transition ) . Subjects were enrolled in Ulaanbaatar during winter and r and omly assigned to oral cholecalciferol ( 1000 IU/day ) versus placebo for 1 month . All children and parents received emollient and patient education about AD and basic skin care . The main outcomes were changes in EASI score and in Investigator 's Global Assessment . RESULTS The 107 enrolled children had a mean age of 9 years ( SD 5 ) , and 59 % were male . Their median age of AD onset was 3 months ( interquartile range 2 months to 1 year ) and mean EASI score at baseline 21 ( SD 9 ) . One-month follow-up data were available for 104 ( 97 % ) children . Compared with placebo , vitamin D supplementation for 1 month produced a clinical ly and statistically significant improvement in EASI score ( adjusted mean change : -6.5 vs -3.3 , respectively ; P = .04 ) . Moreover , change in Investigator 's Global Assessment favored vitamin D over placebo ( P = .03 ) . There were no adverse effects in either group . CONCLUSION Vitamin D supplementation improved winter-related AD among Mongolian children , a population likely to have vitamin D deficiency in winter
target: Vitamin D has a potentially significant role for improving the symptoms of AD .
  The results from this study suggest that vitamin D supplementation may help ameliorate the severity of AD , and can be considered as a safe and tolerable therapy .
background: OBJECTIVES Despite the evidence supporting the use of vitamin D supplements for managing atopic dermatitis ( AD ) , no meta- analysis providing definite conclusions in this field has been reported .
  The purpose of the present study was to conduct a systematic review and meta- analysis of all controlled studies of vitamin D for treating AD to eluci date the efficacy of vitamin D for alleviating the symptoms of AD .