title: Randomized trial of vitamin D supplementation for winter-related atopic dermatitis in children.
abstract: BACKGROUND
  Epidemiologic and preclinical data, and a small randomized trial in Boston, suggest that vitamin D supplementation may improve winter-related atopic dermatitis (AD).
  
  
  OBJECTIVE
  To determine the effect of vitamin D supplementation on winter-related AD.
  
  
  METHODS
  We performed a randomized, double-blind, placebo-controlled trial of Mongolian children with winter-related AD (clinicaltrials.gov identifier: NCT00879424). Baseline eligibility included age 2 to 17 years, AD score 10 to 72 using the Eczema Area and Severity Index (EASI), and winter-related AD (eg, history of AD worsening during the fall-to-winter transition). Subjects were enrolled in Ulaanbaatar during winter and randomly assigned to oral cholecalciferol (1000 IU/day) versus placebo for 1 month. All children and parents received emollient and patient education about AD and basic skin care. The main outcomes were changes in EASI score and in Investigator's Global Assessment.
  
  
  RESULTS
  The 107 enrolled children had a mean age of 9 years (SD 5), and 59% were male. Their median age of AD onset was 3 months (interquartile range 2 months to 1 year) and mean EASI score at baseline 21 (SD 9). One-month follow-up data were available for 104 (97%) children. Compared with placebo, vitamin D supplementation for 1 month produced a clinically and statistically significant improvement in EASI score (adjusted mean change: -6.5 vs -3.3, respectively; P = .04). Moreover, change in Investigator's Global Assessment favored vitamin D over placebo (P = .03). There were no adverse effects in either group.
  
  
  CONCLUSIONS
  Vitamin D supplementation improved winter-related AD among Mongolian children, a population likely to have vitamin D deficiency in winter.
authors.affiliation: Massachusetts General Hospital, Harvard Medical School, and Harvard School of Public Health, Boston, Mass. Electronic address: ccamargo@partners.org.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Camargo
authors.affiliation: Massachusetts General Hospital, Harvard Medical School, and Harvard School of Public Health, Boston, Mass; Health Sciences University of Mongolia, Ulaanbaatar, Mongolia.
authors.forename: D
authors.initials: D
authors.lastname: Ganmaa
authors.affiliation: Seattle Children's Hospital, Seattle, Wash.
authors.forename: Robert
authors.initials: R
authors.lastname: Sidbury
authors.affiliation: Health Sciences University of Mongolia, Ulaanbaatar, Mongolia; National Dermatology Center, Ulaanbaatar, Mongolia.
authors.forename: Kh
authors.initials: Kh
authors.lastname: Erdenedelger
authors.affiliation: Health Sciences University of Mongolia, Ulaanbaatar, Mongolia.
authors.forename: N
authors.initials: N
authors.lastname: Radnaakhand
authors.affiliation: Health Sciences University of Mongolia, Ulaanbaatar, Mongolia; National Dermatology Center, Ulaanbaatar, Mongolia.
authors.forename: B
authors.initials: B
authors.lastname: Khandsuren
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002762:Cholecalciferol / Q000008:administration & dosage* / Q000009:adverse effects; D003876:Dermatitis, Atopic / Q000188:drug therapy*; D019587:Dietary Supplements; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008986:Mongolia; D012621:Seasons; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage* / Q000819:agonists / Q000031:analogs & derivatives
chemical_list: D014807:Vitamin D; D002762:Cholecalciferol
keywords: Mongolia; Randomized controlled trial; atopic dermatitis; children; nutritional supplement; vitamin D; winter