Serum 25-hydroxyvitamin D concentration in patients with psoriasis and rheumatoid arthritis and its association with disease activity and serum tumor necrosis factor-alpha

To assess vitamin D status in psoriasis and rheumatoid arthritis [RA] patients and to study whether it was associated with disease activity, inflammatory markers, and serum tumor necrosis factor-alpha [TNF-alpha]. This cross-sectional study was conducted at Riyadh National Hospital, Riyadh, Saudi Arabia between March and September 2012. It included 43 patients with plaque psoriasis, 55 RA patients and 40 healthy controls matched for age. Blood samples were drawn from all participants for assessment of 25-hydroxyvitamin D [25[OH]D], TNF-alpha, C-reactive protein [CRP], erythrocyte sedimentation rate [ESR], parathyroid hormone [PTH], and serum corrected calcium. Disease activity of psoriasis and RA were assessed using Psoriasis Area and Severity Index [PASI] and Disease Activity Score Index of a 28 joint count [DAS28]. We found a significant difference between psoriatic patients, RA patients, and healthy controls in the mean 25[OH]D [11.74 +/- 3.60, 15.45 +/- 6.42, and 24.55 +/- 11.21 ng/ml; p=0.000]. We found that 25[OH]D was not correlated with PASI, DAS28, TNF-alpha, CRP, or ESR in psoriatic and RA patients. Serum 25-[OH]D levels are significantly lower in psoriatic and RA patients than in healthy control subjects. Low 25-OHD levels also may provide the rationale for vitamin D supplementation in the treatment of psoriasis and RA. More definitive evidence is also required to demonstrate the clinical benefit of vitamin D supplementation in the treatment of psoriasis and RA

Vitamin D deficiency among pre-menopausal women in Riyadh, Saudi Arabia

Riyadh is a region of year-round sunny weather where milk is fortified with vitamin D and where women wear dress styles that cover the whole body or most of it and their outdoor activity is limited. This may produce variable effects on vitamin D synthesis and parathyroid hormone levels which in turn affect bone mineralization, increasing the fracture risk. To determine prevalence and degree of vitamin D deficiency in premenopausal females [19-49 years] presenting to a dermatology clinic. Cross-sectional clinic-based Quota sample. The Dermatology Clinic in Riyadh National Hospital, Riyadh, Saudi Arabia. Three hundred eighty six married adult females [19-49 yrs old] attending the Dermatology Clinic during April and May 2005, and who agreed to be screened. Serum levels of 25-hydroxyvitamin D [25-OHD], parathyroid hormone, calcium, and phosphorus. This study included 386 premenopausal women, most of them [293/75.9%] were veiled [using dress style that is black and covers the whole body], while 93 [24.1%] were not veiled [wearing black dress exposing hands and face], of whom 46 [49%] reported using sunscreen on exposure to sun. Vitamin D deficiency was found in 38.4% of veiled women, with a low serum 25-OHD: 35.2+15.7 nmol/L, compared with 60.8+20.4 amongst the non-veiled women/no sunscreen. Serum 25-OHD amongst the non-veiled women/sunscreen was also low [37.9+17.6] but higher than that in the veiled group. Vitamin D deficiency and insufficiency are prevalent amongst sunlight-deprived female adults [veiled and sunscreen users] in Riyadh. Greater awareness of physicians and population about vitamin D and its importance for optimal health is needed. Increased dietary and supplemental vitamin D intakes are reasonable approaches to guarantee vitamin D sufficiency

Narrow-band UVB decreases epidermal thickness, mast cell density and downregulates IL-8 expression in psoriatic lesions histological and immunohistochemical study

The increased epidermal thickness and number of early activated cutaneous mast cells is a typical feature of psoriatic inflammation. Over expression of IL-8 and its receptor CXCR2 is typically observed in psoriasis lesions and is thought to contribute to keratinocyte dysfunction and to influx of T cells, neutrophils and mast cells. This study was conducted to evaluate epidermal thickness, mast cell density and IL-8 expression in psoriatic lesions before and after narrow-band ultraviolet B [NB-UVB] therapy using histological and immunohistochemical techniques. Twenty five psoriatic patients referred from Dermatology Outpatient Clinics for NB-UVB phototherapy were enrolled in this study. Patients received irradiation with NB-UVB [312 nm, Philips TL01] on the whole body. Four groups were included in this study; control group [1]: normal skin from 5 healthy volunteers], control group [2]: non-lesional control group; normal skin from psoriatic patients,Pre-NB-UVB group: twenty five psoriatic patients and Post- NB-UVB group: psoriatic patients after NB-UVB treatment. Skin biopsies were taken, fixed, processed and stained to assess general skin structure: and epidermal thickness, mast cell density and IL-8 expression by using histological and immunohistochemical procedures. After NB-UVB therapy; there was significant improvement in PASI score and significant decrease in epidermal thickness, mast cell density and optical density of IL-8. NB-UVB therapies targeting epidermal thickness, mast cells or IL-8 should be considered in the treatment of psoriasis