title: Idiopathic itch, rash, and urticaria/angioedema merit serum vitamin D evaluation: a descriptive case series.
abstract: BACKGROUND
  Vitamin D insufficiency is epidemic. Rarely are cutaneous consequences attributed to low vitamin D.
  
  
  METHODS
  A retrospective case series of 63 patients describes an association of pruritus, rash, and urticaria/angioedema with low 25-hydroxyvitamin D (25[OH]D <32 ng/mL). The 90% (57/63) of patients with low vitamin D were treated with 8 to 12 weeks of vitamin D 50,000 IU weekly followed by daily supplementation. Concurrent diagnoses were treated routinely. Complete resolution of cutaneous symptoms defined response.
  
  
  RESULTS
  Patients were 3 to 80 years of age. The 90% (57/63) with low vitamin D (25[OH]D < 32 ng/mL) had a mean age of 47 (11 to 80) years old, 70% were atopic, and 77% were female. Median duration of idiopathic cutaneous symptoms was 18 months. Mean 25[OH]D was 18.0 ng/mL. With vitamin D treatment 70% (40/57) had complete resolution of symptoms. Mean 25[OH]D for vitamin D responsive patients (16.8 ng/mL) was significantly lower than for vitamin D non-responsive treated patients (20.9 ng/mL, P = 0.02 by unpaired t-Test). Resolution of cutaneous symptoms with vitamin D supplementation occurred in a mean of 4.2 weeks. Symptom recurrence was seen in subsequent months only if vitamin D insufficiency recurred.
  
  
  CONCLUSIONS
  This retrospective case-series, with a 70% (40/57) vitamin D treatment success, suggests that vitamin D status should be assessed in patients with idiopathic cutaneous symptoms. If vitamin D is low, symptom resolution is often possible with oral supplementation of vitamin D. Controlled clinical studies are required to confirm these associations.
authors.affiliation: Exemplar Allergy & Asthma, Morgantown, WV, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Goetz
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000799:Angioedema / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D014581:Urticaria / Q000175:diagnosis; D014807:Vitamin D / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000175:diagnosis* / Q000188:drug therapy*
chemical_list: D014807:Vitamin D