Departments of Dermatology, Endocrinology and Metabolism, Paediatrics, Biostatistics and Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
Br J Dermatol. 2012 Mar;166(3):608-15. doi: 10.1111/j.1365-2133.2011.10672.x.
Ichthyosiform erythroderma due to keratinizing disorders may suppress cutaneous vitamin D synthesis, leading to vitamin D deficiency and rickets.
To determine the prevalence of vitamin D deficiency and rickets in children and adolescents with congenital ichthyosis and other keratinizing disorders with erythroderma and scaling.
In this cross-sectional study, 45 children and adolescents with ichthyosiform erythroderma due to keratinizing disorders, and 66 controls (group 1: age and sex matched, with skin diseases other than keratinizing disorders; group 2: age and sex matched, healthy volunteers) were included. Evidence of rickets was determined clinically (physical examination and radiographs) and biochemically {serum calcium, phosphorus, alkaline phosphatase, 25-hydroxy vitamin D [25(OH)D] and parathyroid hormone (PTH)}.
All patients in the disease group had clinical, radiological or biochemical evidence of rickets [25(OH)D<20ngmL(-1) ], and analysis was done for all subjects with the available biochemical reports. The mean serum 25(OH)D levels of the disease group was 8·38±5·23ngmL(-1) and was significantly lower than in control group 1 (11·1±5·8ngmL(-1) ) (P<0·01) and control group 2 (13·5±6·9ngmL(-1) ) (P<0·001). The prevalence of vitamin D deficiency [25(OH)D<20ngmL(-1) ] was significantly higher in the disease group (n=38 of 39, 97·4%) than in control group 2 (n=12, 70·6%) (P<0·01), and total controls (n=56, 84·8%) (P=0·04). The frequency of hyperparathyroidism (PTH>65pgmL(-1) ) was also significantly higher in the disease group than in controls (P<0·01).
Children and adolescents with various forms of ichthyosiform erythroderma, especially those with pigmented skin (types IV-VI), are at increased risk of developing vitamin D deficiency and clinical rickets.
角化障碍引起的鱼鳞样红皮病可能会抑制皮肤维生素 D 的合成,导致维生素 D 缺乏和佝偻病。
确定角化障碍性鱼鳞样红皮病患儿和青少年中维生素 D 缺乏和佝偻病的患病率,这些患儿和青少年患有红皮病和鳞屑,并伴有角化障碍。
在这项横断面研究中,纳入了 45 例角化障碍性鱼鳞样红皮病患儿和青少年(疾病组),以及 66 例对照者(第 1 组:年龄和性别匹配,患有非角化障碍性皮肤病;第 2 组:年龄和性别匹配,健康志愿者)。通过临床(体格检查和 X 线检查)和生化检查(血清钙、磷、碱性磷酸酶、25-羟维生素 D[25(OH)D]和甲状旁腺激素[PTH])确定佝偻病的证据。
疾病组所有患者均存在临床、放射学或生化证据提示佝偻病[25(OH)D<20ng/mL],并对所有有生化报告的受试者进行了分析。疾病组的平均血清 25(OH)D 水平为 8.38±5.23ng/mL,明显低于第 1 对照组(11.1±5.8ng/mL)(P<0.01)和第 2 对照组(13.5±6.9ng/mL)(P<0.001)。疾病组维生素 D 缺乏症[25(OH)D<20ng/mL]的患病率(n=39 例中的 38 例,97.4%)明显高于第 2 对照组(n=12 例,70.6%)(P<0.01)和所有对照组(n=56 例,84.8%)(P=0.04)。疾病组甲状旁腺激素(PTH>65pg/mL)升高的频率也明显高于对照组(P<0.01)。
各种形式的鱼鳞样红皮病患儿和青少年,特别是色素沉着皮肤(IV-VI 型)患者,发生维生素 D 缺乏和临床佝偻病的风险增加。