WB: Vitamin D Levels Are Correlated With Disease Severity in Psoriasis

Dermatologists should explore general vitamin D therapy for patients with psoriasis at risk for vitamin D insufficiency.

Previous research has identified an association between vitamin D and immune regulation throughout the body, according to Alpana Mohta, MD. “Clarity, however, is lacking regarding vitamin D deficiency as an etiological factor in psoriasis or as a consequence of untreated disease proliferation,” she says.

For a study published in the Indian Journal of Dermatology, Dr. Mohta and colleague Asha Nyati, MD, aimed to determine correlations between the serum vitamin D level of patients with psoriasis and disease severity. Dr. Mohta recently spoke with Physician’s Weekly about the findings.

PW: What was your rationale for identifying a correlation between psoriasis severity and vitamin D deficiency?

Dr. Mohta: In India, we have a massive patient burden of both vitamin D deficiency and psoriasis. While there is a considerable amount of research about the effects of vitamin D on bone health, there is a lack of consensus on its role in skin diseases like psoriasis.

Previous research has found a correlation between vitamin D receptor polymorphisms and psoriasis susceptibility. Given that vitamin D is involved in skin cell differentiation and maturation and is crucial in preserving the homeostasis of the epidermal barrier, we surmised that investigating its correlation with psoriasis severity would provide valuable insights into the underlying mechanisms of the disease. We also wanted to explore the relationship between vitamin D and psoriasis to improve patient outcomes.

PW: What is the key takeaway for physicians?

Dr. Mohta: Our study found a high prevalence of vitamin D deficiency in patients with psoriasis, and its level are strongly associated with every aspect of disease severity, including the Psoriasis Area and Severity Index, Erythrocyte Sedimentation Rate, and the presence of comorbidities like metabolic syndrome (Table). Vitamin D levels can predict the course of psoriasis and its prognosis.

PW: How can these findings be incorporated into practice?

Dr. Mohta: Physicians can use serum vitamin D levels to assess psoriasis severity and monitor treatment response. They can also consider vitamin D supplementation in patients with psoriasis to improve disease outcomes in those with low vitamin D levels.

PW: What would you like future research to focus on?

Dr. Mohta: Future research should explore the efficacy of vitamin D supplementation in improving psoriasis outcomes and the long-term effects of maintaining adequate vitamin D levels in patients with psoriasis. Additionally, more studies are needed to establish the underlying mechanisms of the causal relationship between vitamin D deficiency and psoriasis.

PW: What else should readers know about your research?

Dr. Mohta: As a dermatologist, I have seen firsthand the impact that psoriasis can have on a patient’s QOL. By exploring the link between vitamin D deficiency and psoriasis, we can potentially identify new treatment avenues and improve patient outcomes.

Vitamin D is essential for keratinocyte proliferation and maturation, making it a potential therapy for psoriasis treatment. While the precise association between vitamin D and psoriasis etiology is unknown, it is critical to recognize their potential bidirectional influence on psoriasis comorbidities such as type 2 diabetes, obesity, and metabolic syndrome.

Despite inconsistent information on the benefits of vitamin D supplementation in psoriasis, it represents an unmet therapeutic need, and dermatologists and nutritionists should explore general vitamin D therapy for patients with psoriasis at risk for vitamin D insufficiency.