Vitamin D Status in Patients with Plaque Psoriasis: Relation to Disease Severity

Abstract

https://doi.org/10.31386/dmj.2025.19.1.4

ABSTRACT

There is increasing evidence on the association between vitamin D insufficiency and   plaque   psoriasis, but the impact of vitamin D status on disease severity and vice versa has not been well reported. Our aim was to investigate the level of 25-hydroxyvitaminD [25(OH)D] and the prevalence of vitamin D abnormalities in patients with plaque psoriasis and in those without psoriasis and to ascertain the impact of 25(OH)D levels on disease severity and vice versa. This case-control study was conducted at the Dermatology Outpatient Clinic, Azadi Teaching Hospital from November 2018 to March 2019, which included 77 adult patients with plaque psoriasis and 109 healthy individuals. The two groups were matched for age, sex and BMI. The Psoriasis Area and Severity Index (PASI) of disease were determined and categorized as follow: Mild-to-Moderate: PASI score <12 and severe –PASI score >12.Vitamin D status was assessed by measurement of serum 25(OH)D concentrations. Significantly lower 25(OH)D levels (p<0.001) were found in psoriatic patients compared to healthy individuals.  The mean 25(OH)D was lower in patients with severe disease state in comparison with that for mild or mild-to-moderate severity (P=0.170 and p= 0.057, respectively).Patients with insufficient 25(OH)D <20 ng/ml had a higher PASI score compared to those with adequate 25(OH)D >20 ng/ml (16.30 vs. 11.35, p=0.032).The vitamin D deficiency quantitated by 25(OH)D <10 ng/ml was detected in 19(24.7%) of patients with plaque psoriasis as compared to 13(11.9%) in healthy individuals(p<0.010). A low vitamin status is present in the majority of patients with plaque psoriasis, particularly among those with severe disease. This may reflect the additive effect of vitamin D status on disease severity.