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Sunlight exposure behaviour and vitamin D status in photosensitive patients: longitudinal comparative study with healthy individuals at U.K. latitude.
Br J Dermatol. 2014 Dec; 171(6):1478-86.BJ

Abstract

BACKGROUND

Low vitamin D status is prevalent in wintertime in populations at northerly latitudes. Photosensitive patients are advised to practise sun avoidance, but their sunlight exposure levels, photoprotective measures and resulting vitamin D status are unknown.

OBJECTIVES

To examine seasonal vitamin D status in photosensitive patients relative to healthy individuals and to assess quantitatively behavioural and demographic contributors.

METHODS

This was a longitudinal prospective cohort study (53·5°N) examining year-round 25-hydroxyvitamin D [25(OH)D] levels, sun-exposure behaviour and oral vitamin D intake in photosensitive patients diagnosed at a photoinvestigation unit (n = 53), compared with concurrently assessed healthy adults (n = 109).

RESULTS

Photosensitive patients achieved seasonal 25(OH)D variation, but insufficient (< 20 ng mL(-1); 50 nmol L(-1)) and even deficient (< 10 ng mL(-1); 25 nmol L(-1)) levels occurred at the summer peak in 47% and 9% of patients, respectively, rising to 73% and 32% at the winter trough. Adjusting for demographic factors, the mean values were lower than for healthy volunteers by 18% [95% confidence interval (CI) 4-29] in summer (P = 0·02) and 25% (95% CI 7-39) in winter (P = 0·01). Behavioural factors explained 25(OH)D differences between cohorts. Patients demonstrated lower weekend ultraviolet B doses (P < 0·001), smaller skin surface area exposure (P = 0·004) and greater sunscreen use (P < 0·001), while average oral vitamin D intake was low in both groups (photosensitive: 2·94 μg per day). Supplementation and summer surface area exposure predicted summer peak and winter trough 25(OH)D levels. A 1 μg per day increment in supplementary vitamin D raised summer and winter 25(OH)D by 5% (95% CI 3-7) and 9% (95% CI 5-12), respectively (both P < 0·001).

CONCLUSIONS

Photosensitive patients are, through their photoprotective measures, at high risk of year-round low vitamin D status. Guidance on oral measures should target this patient group and their physicians.

Authors+Show Affiliations

Dermatology Centre, Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, U.K.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25110159

Citation

Rhodes, L E., et al. "Sunlight Exposure Behaviour and Vitamin D Status in Photosensitive Patients: Longitudinal Comparative Study With Healthy Individuals at U.K. Latitude." The British Journal of Dermatology, vol. 171, no. 6, 2014, pp. 1478-86.
Rhodes LE, Webb AR, Berry JL, et al. Sunlight exposure behaviour and vitamin D status in photosensitive patients: longitudinal comparative study with healthy individuals at U.K. latitude. Br J Dermatol. 2014;171(6):1478-86.
Rhodes, L. E., Webb, A. R., Berry, J. L., Felton, S. J., Marjanovic, E. J., Wilkinson, J. D., Vail, A., & Kift, R. (2014). Sunlight exposure behaviour and vitamin D status in photosensitive patients: longitudinal comparative study with healthy individuals at U.K. latitude. The British Journal of Dermatology, 171(6), 1478-86. https://doi.org/10.1111/bjd.13325
Rhodes LE, et al. Sunlight Exposure Behaviour and Vitamin D Status in Photosensitive Patients: Longitudinal Comparative Study With Healthy Individuals at U.K. Latitude. Br J Dermatol. 2014;171(6):1478-86. PubMed PMID: 25110159.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sunlight exposure behaviour and vitamin D status in photosensitive patients: longitudinal comparative study with healthy individuals at U.K. latitude. AU - Rhodes,L E, AU - Webb,A R, AU - Berry,J L, AU - Felton,S J, AU - Marjanovic,E J, AU - Wilkinson,J D, AU - Vail,A, AU - Kift,R, Y1 - 2014/10/26/ PY - 2014/08/04/accepted PY - 2014/8/12/entrez PY - 2014/8/12/pubmed PY - 2015/8/19/medline SP - 1478 EP - 86 JF - The British journal of dermatology JO - Br J Dermatol VL - 171 IS - 6 N2 - BACKGROUND: Low vitamin D status is prevalent in wintertime in populations at northerly latitudes. Photosensitive patients are advised to practise sun avoidance, but their sunlight exposure levels, photoprotective measures and resulting vitamin D status are unknown. OBJECTIVES: To examine seasonal vitamin D status in photosensitive patients relative to healthy individuals and to assess quantitatively behavioural and demographic contributors. METHODS: This was a longitudinal prospective cohort study (53·5°N) examining year-round 25-hydroxyvitamin D [25(OH)D] levels, sun-exposure behaviour and oral vitamin D intake in photosensitive patients diagnosed at a photoinvestigation unit (n = 53), compared with concurrently assessed healthy adults (n = 109). RESULTS: Photosensitive patients achieved seasonal 25(OH)D variation, but insufficient (< 20 ng mL(-1); 50 nmol L(-1)) and even deficient (< 10 ng mL(-1); 25 nmol L(-1)) levels occurred at the summer peak in 47% and 9% of patients, respectively, rising to 73% and 32% at the winter trough. Adjusting for demographic factors, the mean values were lower than for healthy volunteers by 18% [95% confidence interval (CI) 4-29] in summer (P = 0·02) and 25% (95% CI 7-39) in winter (P = 0·01). Behavioural factors explained 25(OH)D differences between cohorts. Patients demonstrated lower weekend ultraviolet B doses (P < 0·001), smaller skin surface area exposure (P = 0·004) and greater sunscreen use (P < 0·001), while average oral vitamin D intake was low in both groups (photosensitive: 2·94 μg per day). Supplementation and summer surface area exposure predicted summer peak and winter trough 25(OH)D levels. A 1 μg per day increment in supplementary vitamin D raised summer and winter 25(OH)D by 5% (95% CI 3-7) and 9% (95% CI 5-12), respectively (both P < 0·001). CONCLUSIONS: Photosensitive patients are, through their photoprotective measures, at high risk of year-round low vitamin D status. Guidance on oral measures should target this patient group and their physicians. SN - 1365-2133 UR - https://www.unboundmedicine.com/medline/citation/25110159/Sunlight_exposure_behaviour_and_vitamin_D_status_in_photosensitive_patients:_longitudinal_comparative_study_with_healthy_individuals_at_U_K__latitude_ L2 - https://doi.org/10.1111/bjd.13325 DB - PRIME DP - Unbound Medicine ER -