Lower Vitamin D Levels Linked to Increased Severity of Pemphigus Vulgaris: Study

A new study published in The Journal of the Pakistan Medical Association found a negative correlation between serum vitamin D levels and the severity of pemphigus vulgaris in a new study thereby suggesting that lower vitamin D levels may be associated with more severe disease manifestations.

Intraepidermal acantholysis is a feature of a group of skin diseases that includes pemphigus vulgaris (PV), a chronic autoimmune bullous condition. Globally, it affects 0.76 to 16.1 people per million. Vitamin D receptors are expressed by both T and B cells, suggesting that vitamin D may play an active role in immunity and immunological regulation. According to studies, calcitriol increases the number of circulating T cells while suppressing the generation of T cell cytokines.

One hormone that helps the body maintain the ideal levels of calcium and phosphorus is vitamin D. It is also a significant immunomodulator, and low vitamin D levels have been linked to a number of autoimmune disorders. Reduced vitamin D levels are frequently observed in numerous communities around the globe. By determining the vitamin D level in PV patients and the relationship between PV and disease severity, the current study aimed to close a gap in the literature.

The patients with pemphigus vulgaris, as determined by histology and direct immunofluorescence, were included in the prospective, cross-sectional study, which was carried out at the Department of Dermatology, Lady Reading Hospital, Peshawar, Pakistan, between December 2021 and June 2022.

To reduce inter-observer bias, a skilled dermatologist evaluated the patients at baseline, and each patient's Pemphigus Disease Area Index score was determined. Using the enzyme-linked immunosorbent assay method, blood samples were extracted from the medial cubital vein and centrifuged at 3000 rpm for 10 minutes at 40°C to determine the serum vitamin D levels. SPSS 22 was used to analyze the data.

Almost, 40 (49.9%) of the 89 patients were male, and 40 (55.1%) were female. 38.48±13.365 years was the average age. 66 patients (74.2%) had vitamin D deficiency, while 7 patients (7.9%) had vitamin D insufficiency. The patients' mean vitamin D level was 17.4882±14.70505 mg/dl. Vitamin D level and illness severity had a negative but non-significant connection (r = -0.131, p = 0.22).

Age, gender, place of residence, socioeconomic position, length of illness, and educational attainment did not significantly correlate with vitamin D insufficiency (p>0.05). Overall, the results of this study indicate a negative relationship between the severity of pemphigus vulgaris and serum vitamin D levels, indicating that more severe disease symptoms may be linked to lower vitamin D levels.

Source:

Paracha, M. M., Khan, A. Q., Sardar, A., Kamal, K., Ikram, A., & Noor, S. M. (2025). Correlation and assessment of vitamin D deficiency with disease severity in patients suffering from pemphigus vulgaris. JPMA. The Journal of the Pakistan Medical Association, 75(5), 726–729. https://doi.org/10.47391/JPMA.11552