Kaşıntı ve D Vitamini
Özet
Pruritus (kaşıntı), deride kaşıma isteği uyandıran ve altı haftadan uzun sürdüğünde kronikleşen, hastaların yaşam kalitesini önemli ölçüde düşüren dermatolojik bir semptomdur. Kronik pruritus; dermatolojik, sistemik, nörolojik ve psikiyatrik hastalıklara bağlı gelişebileceği gibi, hastaların yüzde 20'sinde nedeni bilinmemektedir. D vitamini deride antiproliferatif, keratinosit farklılaşmasını düzenleyici ve immünmodulatör etkiler göstererek kutanöz inflamasyonu azaltır. Yapılan çalışmalar, D vitamini ve analoglarının çeşitli kaşıntılı hastalıklarda alternatif bir tedavi seçeneği olabileceğini ortaya koymaktadır. Prurigo nodulariste topikal D vitamini kullanımı (takalsitol, kalsipotriol) nodüllerin sayı ve çapında anlamlı azalmalar sağlamaktadır. Psoriasis ilişkili pruritusta ise D vitamini analogları kutanöz inflamasyonu ve kaşıntı semptomlarını belirgin ölçüde geriletmektedir. Kronik böbrek hastalığına bağlı gelişen üremik pruritusta D vitamini eksikliği rol oynamakta ve topikal kalsipotriol tedavisi cilt kuruluğunu azaltarak kaşıntı üzerinde anlamlı üstünlük göstermektedir. Ayrıca nedeni bilinmeyen kronik pruritusu olan hastalarda D vitamini seviyelerinin anlamlı derecede düşük saptandığı ve D vitamini takviyesinin semptomları iyileştirdiği bildirilmiştir. Sonuç olarak, kaşıntı mekanizmalarında D vitamininin otokrin ve parakrin fonksiyonları önemli bir yere sahip olup, tedavi kılavuzlarında rutin olarak yer almasa da eksiklik durumlarında takviyesi önerilmektedir.
Pruritus (itching) is a dermatological symptom that induces the desire to scratch and, when lasting longer than six weeks, becomes chronic, significantly impairing patients' quality of life. Chronic pruritus can develop due to dermatological, systemic, neurological, and psychiatric diseases, while its cause remains unknown in 20% of patients. Vitamin D exerts antiproliferative, keratinocyte differentiation-regulating, and immunomodulatory effects in the skin, thereby reducing cutaneous inflammation. Studies reveal that vitamin D and its analogs can be an alternative treatment option in various pruritic diseases. In prurigo nodularis, the topical use of vitamin D (tacalcitol, calcipotriol) provides significant reductions in the number and diameter of nodules. In psoriasis-associated pruritus, vitamin D analogs markedly regress cutaneous inflammation and itching symptoms. Vitamin D deficiency plays a role in uremic pruritus associated with chronic kidney disease, and topical calcipotriol therapy shows significant superiority over itching by reducing skin dryness. Furthermore, it has been reported that vitamin D levels are significantly lower in patients with chronic pruritus of unknown origin, and vitamin D supplementation improves symptoms. Consequently, the autocrine and paracrine functions of vitamin D hold an important place in itching mechanisms, and although not routinely included in treatment guidelines, its supplementation is recommended in cases of deficiency.
Referanslar
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Yıldız Seçkin H, Bütün İ, Baş Y, Takcı Z. Kronik Pruritusta D Vitamini Eksikliği Dermatoz, 2016 (Yayın No: 2727651) doi: 10.15624.dermatoz16073a1
