Vitamin D in dermatology

The fundamental role of vitamin D in health and disease is constantly expanding. The major sources of the "sunshine vitamin" are sunlight exposure with subsequent cutaneous synthesis and oral intake in the form of supplementation or dietary consumption. Not only crucial for skeletal health, vitamin D is also linked to numerous disorders of cardiovascular, neurologic, reproductive, infectious, autoimmune, and dermatologic origins. It is a pleiotropic fat-soluble hormone that affects key factors in the pathogenesis of numerous cutaneous disorders because of its effects on the innate and adaptive immune systems and the physiology of the skin, including the integrity of the epidermal barrier. Thus, it is implicated in the development and severity of many dermatoses. Vitamin D status is dependent on numerous modifiable and nonmodifiable factors including Fitzpatrick skin type, sun exposure, sex, body mass index, physical activity, alcohol intake, season, and latitude, in addition to polymorphisms in the vitamin D receptor. In view of increasing knowledge about the overall benefits of vitamin D, it now seems necessary to focus on reaching and maintaining an optimal vitamin D status. This article will discuss the potential determinants as well as the advantages of adequate vitamin D levels, with a special focus on the skin.