COMPARISON BETWEEN VITAMIN D SUPPLEMENTATION VERSUS NARROW BAND ULTRAVIOLET B AS AN ADDED-ON TREATMENT IN ALOPECIA AREATA

Abstract

A lopecia areata (AA) is a common non-scarring, autoimmune, inflammatory hair loss on the scalp and/or body. It is an organ-specific, T-cell-mediated autoimmune disease that targets hair follicles. Many etiological factors have been suggested to contribute to the development of AA. These include hair follicle growth cycling modulation, genetic factors, autoimmune pathogenesis, environmental impact, minerals and vitamins and oxidative stress. It can present as patchy AA, alopecia totalis (AT) involving the entire scalp and body hair such as eyebrows, eyelashes, beard, axillary hair and pubic hair and alopecia universalis (AU) if the total body hair is involved. First-line therapies of AA commonly include intralesional or topical corticosteroids, and in some institutions, topical immunotherapy. The course of AA is unpredictable. Up to 50% of patients will recover within 1 year even without treatment. Vitamin D is a steroid hormone that is synthesized in the epidermal keratinocytes under influence of UV-B light (290-320 nm) or acquired in the diet and dietary supplements. Serum levels of vitamin D have been found to be significantly lower in patients with prevalent autoimmune disease, including AA. Vitamin D has been found to have immuno-regulatory effects. 1,25-Dihydroxyvitamin D3 (1,25(OH)2D3) which is the major form of vitamin D, is a modulator of immune function including activities of T-lymphocytes and B-lymphocytes as well as having a role in immune responses. Treatment of vitamin D-deficient individuals should be initiated with 50,000 IU of oral vitamin D2 or D3 weekly for a period of 8 to 12 weeks.