Friday, March 11, 2011
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Eczema is a form of atopy, a disease characterized by a tendency to be "hyperallergic". A patient with atopic allergies often has atopic eczema or atopic dermatitis since infancy and asthma as they grow older. Atopic eczema is an extremely itchy skin condition with a hallmark rash that can involve almost every region of the body. Crusty, scaly, flattened, reddened lesions of atopic eczema can appear almost everywhere, but are worse in certain areas or after exposure to certain irritants (e.g., allergenic soap, freshly cut lawns).
The single most important feature associated with atopic eczema lesions is that they are extremely itchy, and the itch can occur even before the lesions erupt on the skin and are visible. The itchiness often leads to secondary infections.
Atopy and asthma have a complicated relationship to vitamin D, with some studies showing vitamin D — especially cod liver oil in infancy — making eczema worse in later life. However, one would be silly to stay vitamin D deficient, and all that entails, on the chance your eczema will not worsen. Furthermore, in my experience atopy, including asthma, will slowly improve with physiological doses of vitamin D. Like asthma, eczema can become life-threatening if infection occurs. Such infections are thought to be secondary to reductions in the skin of naturally occurring antibiotics, such as cathelicidin.
Recently, Dr. Tissa Hata and a group at UC San Diego conducted a randomized controlled trial that demonstrated a remarkable seven-fold increase in cathelicidin in the skin after adult eczema subjects were given 4,000 IU per day for 21 days.
Hata TR, et al. Administration of oral vitamin D induces cathelicidin production in atopic individuals. J Allergy Clin Immunol. 2008 Oct;122(4):829—31.
Even more important, Dr. Urashima and colleagues at the Jikei University School of Medicine in Japan conducted a randomized placebo controlled trial of young teenagers and found that those with asthma were much less likely to have an attack if they were on vitamin D. Asthma attacks are not an uncommon cause of death among children. They also found that vitamin D significantly reduced the risk of influenza A, which can be much more severe in asthmatics.
Urashima M, et al. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 2010 May;91(5):1255—60.
Geoffrey, both you and your baby need to stop all vitamin A supplements, as they will interfere with the vitamin D, and begin taking vitamin D; your infant needs 1,000 IU/day and you need 5,000 IU per day. I wish I could tell you the eczema will rapidly disappear; it will not. However, over a period of several years I predict both the eczema and asthma will slowly improve. More importantly, both you and your infant will have a decreased likelihood of getting a secondary infection in both your skin and your lungs.
John Jacob Cannell MD Executive Director
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Posted by Eczema Mom at 7:06 PM