Vitiligo y vitamina D

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Artículo de revisión
Rev Asoc Colomb Dermatol. 2019; 27 : 1 (enero - marzo), 36-51

Vitiligo y vitamina D

Vitiligo and vitamin D
Autor(es): 
Óscar Jairo Valencia Ocampo
oscar.valencia@udea.edu.co
Médico dermatólogo; docente de Dermatología, Universidad de Antioquia, Medellín, Colombia. Centro de Investigaciones Dermatológicas CIDERM
Andrea Castaño Villegas
Médica, residente de Dermatología, Universidad de Antioquia, Medellín, Colombia
Catalina Moreno Zuluaga
Médica, residente de Dermatología, Universidad de Antioquia, Medellín, Colombia
Leonardo Javier Medina Albis
Médico dermatólogo; docente de Dermatología, Universidad de Antioquia, Medellín, Colombia. Centro de Investigaciones Dermatológicas CIDERM
Resumen: 

 

El vitiligo es la despigmentación cutánea adquirida más común. Se caracteriza por máculas acrómicas que afectan la autoimagen de los pacientes e impactan negativamente su calidad de vida. En cuanto a las teorías sobre la etiopatogénesis del vitiligo, está la autoinmunidad. Se ha demostrado que hay un déficit de vita­mina D en numerosas enfermedades autoinmunitarias.

La vitamina D es una hormona esencial con efectos pleiotrópicos y funciones es­pecialmente antiapoptóticas y modificadoras de la proliferación y diferenciación de los melanocitos. Hipotéticamente, puede desempeñar un papel coadyuvante en la repigmentación de las lesiones vitiliginosas. La actividad inmunorregula­dora de la vitamina D podría ser utilizada en el tratamiento del vitiligo.

A continuación, se hace una revisión de tema sobre el vitiligo, su relación con las concentraciones de la vitamina D y las influencias que podría tener en la fisiopa­tología; además, se analiza su posible uso como herramienta terapéutica para el vitiligo. El comportamiento de los niveles de vitamina D en rangos de deficiencia e insuficiencia entre pacientes con vitiligo y controles sanos son controversiales; algunos muestran niveles más bajos en el grupo de vitiligo y otros no muestran diferencias entre los grupos. A pesar de lo anterior, los estudios recientes sugieren una relación entre la insuficiencia de vitamina D en pacientes con vitiligo y un riesgo mayor de padecer otras enfermedades autoinmunitarias y que el uso de dosis altas de vitamina D en pacientes con vitiligo podría mejorar la repigmen­tación. La información revisada permite concluir que la relación entre el vitiligo y los niveles de vitamina D requiere de más estudios que aclaren su papel en la inmunopatogénesis y en la probabilidad de recomendar su uso terapéutico.

Palabras clave: 
Vitiligo, vitamina D, Melanocitos, deficiencia de vitamina D

Summary: 

Vitiligo is the most common acquired skin depigmentation. It is characterized by acromic macules that affect the self-image of patients and negatively im­pact their quality of life. Among the theories about the etiopathogenesis of vitiligo, is autoimmunity. Vitamin D deficiency has been demonstrated in nu­merous autoimmune diseases.

Vitamin D is an essential hormone with pleiotropic effects, and especially antiapoptotic functions and modifiers of the proliferation and differentiation of melanocytes. Hypothetically, it can play a coadju­vant role in the repigmentation of vitiliginous le­sions. The immunoregulatory activity of vitamin D could be used in the treatment of vitiligo.

Next, there is a review of the subject on vitiligo, its relationship with the concentrations of vitamin D and the influences that could have on the physio­pathology. In addition, its possible use as a thera­peutic tool for vitiligo is analyzed. The behavior of vitamin D levels in deficiency and insufficiency ranges between vitiligo patients and healthy con­trols are controversial, some show lower levels in the vitiligo group and others do not show di­fferences between the groups. Despite the above, recent studies suggest a relationship between vi­tamin D insufficiency in patients with vitiligo and a higher risk of suffering from other autoimmune diseases and that the use of high doses of vitamin D in patients with vitiligo could improve the repig­mentation. The information reviewed allows us to conclude that the relationship between vitiligo and vitamin D levels requires more studies to clarify its role in immunopathogenesis and the likelihood of recommending its therapeutic use.

Key words: 
Vitiligo, Vitamin D, Melanocytes, vitamin D deficiency
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