Pediatric Allergy and Immunology

CORRESPONDENCE

Vitamin D and atopic dermatitis: Association, causation, or confusion? To the Editor, We read with interest the recent article by Wang et al. (1) that reported a potential association between vitamin D deficiency and severity of atopic dermatitis (AD) in children in Hong Kong. This subject is topical and studies to date that have investigated a potential link between the two have yielded contradictory findings. Although the study by Wang et al. has some merits, we have significant concerns regarding the study methodology, analysis, and interpretation and feel the authors have overstated their conclusions. We believe cautious interpretation of the study finding is warranted. Given the overall findings, the title of the manuscript is misleading as it implies a strong correlation between vitamin D deficiency and severity of atopic dermatitis that is not supported by the data presented. From the outset, the aim of the study does not appear to have been clearly defined. If the authors were endeavoring to show a causal association between vitamin D and AD, we would question the use of case–control study design that makes it impossible to determine whether the vitamin D deficiency preceded the development of or was the result of the AD in this population. Although the mean vitamin D levels (single measurement) were higher in the ‘control’ compared to the AD group overall (mean [s.d.]: 34.2 [14.5] vs. 28.9 [15.3] nM; p < 0.001), the proportion of children deemed to have vitamin D insufficiency (

Vitamin D and atopic dermatitis: association, causation, or confusion?

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