Serum Zinc, Selenium and Vitamin D Levels in Seborrheic Dermatitis: A Case-Control Study

Öz

Aim: Chronic inflammation of the skin is a hallmark of seborrheic dermatitis (SD) with relapsing episodes and unknown etiology, which affects the patients' quality of life. Studies suggest that a lack of vitamins and minerals could influence the course of the disease. In this case-control study, serum vitamin D, selenium, and zinc levels of patients with SD were compared with those of a healthy control group. Material and Methods: The study included 152 patients with SD and 129 healthy controls, from whom demographic data and blood samples were collected. Disease severity was assessed using the SEDASI scoring system. Serum vitamin D and zinc levels were measured using ELISA and photometric methods, while selenium levels were also determined. Statistical analyses were performed using SPSS version 27 and JAMOVİ software, and chi-square tests were also conducted. Statistical significance was defined as p < 0.05 for all tests. Results: No significant difference in zinc levels was observed between the groups (p=0.750). However, selenium (p<0.001) and The patient group exhibited statistically significantly lower vitamin D levels (p=0.036) than the control group. Furthermore, A statistically significant negative correlation was observed between selenium levels and disease severity Conclusion: In the study, The patient and control groups showed significant differences regarding selenium and vitamin D levels. Additionally, Disease severity and selenium levels were negatively correlated. These findings highlight the need for further research regarding the potential therapeutic role of nutritional supplementation in the management of SD.

Anahtar Kelimeler

• Seborrheic dermatitis
• selenium
• vitamin D
• zinc

Seboreik dermatitte serum Çinko, Selenyum ve D vitamini düzeyleri: vaka kontrol çalışması

Öz

Amaç: Seboreik dermatit (SD), relapslarla seyreden, etiyolojisi bilinmeyen, hastaların yaşam kalitesini etkileyen kronik bir inflamatuvar cilt hastalığıdır. Yapılan çalışmalar, vitamin ve mineral eksikliklerinin hastalığın seyrini etkileyebileceğini öne sürmektedir. Bu vaka-kontrol çalışmasında SD hastalarında serum D vitamini, selenyum ve çinko düzeyleri sağlıklı kontrol grubuyla karşılaştırılarak değerlendirildi. Gereç ve Yöntemler: Çalışmaya 152 SD hastası ve 129 sağlıklı kontrol, demografik veriler ve kan örnekleri sağlanarak katıldı. Hastalığın şiddeti SEDASI puanlama sistemi kullanılarak değerlendirildi. Serum D vitamini, selenyum ve çinko düzeyleri ELISA ve fotometrik yöntemler kullanılarak ölçüldü. İstatistiksel analizler SPSS v27 ve JAMOVI yazılımları ile gerçekleştirildi ve ki-kare testleri kullanılarak gerçekleştirildi. Tüm testlerde istatistiksel anlamlılık düzeyi p < 0.05 olarak kabul edildi. Bulgular: Gruplar arasında çinko düzeyleri açısından anlamlı bir fark saptanmadı (p=0.750). Ancak selenyum (p<0.001) ve D vitamini düzeyleri (P=0.036) hasta grubunda kontrol grubuna göre istatiksel olarak anlamlı olacak şekilde daha düşük saptandı. Ayrıca selenyum düzeyleri ile hastalık şiddeti arasında ters korelasyon saptandı. Sonuç: Çalışmada selenyum ve D vitamini düzeyleri açısından hasta ve kontrol grubunda belirgin fark saptandı. Ayrıca hastalık şiddeti ile selenyum düzeyleri arasında ters korelasyon mevcuttu. Bu bulgular, SD'nin yönetiminde besin takviyesinin potansiyel terapötik rolüne ilişkin daha fazla araştırma yapılması gerektiğini vurgulamaktadır.

Anahtar Kelimeler

• seboreik dermatit
• selenyum
• vitaminD
• çinko

Kaynakça

1. J. A. Adalsteinsson, S. Kaushik, S. Muzumdar, E. Guttman‐Yassky, and J. Ungar, “An Update on the Microbiology, Immunology and Genetics of Seborrheic Dermatitis,” Experimental Dermatology 29, no. 5 (2020): 481–489.
2. F. Dall'Oglio, M. R. Nasca, C. Gerbino, and G. Micali, “An Overview of the Diagnosis and Management of Seborrheic Dermatitis,” Clinical, Cosmetic and Investigational Dermatology 15 (2022): 1537–1548.
3. A. Akbaş, F. Kılınç, S. Şener, and Y. Hayran, “Investigation of the Relationship Between Seborrheic Dermatitis and Metabolic Syndrome Parameters,”Journal of Cosmetic Dermatology 21, no. 11 (2022): 6079–6085.
4. J. Sowell, S. M. Pena, and B. E. Elewski, “Seborrheic Dermatitis in Older Adults: Pathogenesis and Treatment Options,” Drugs & Aging 39, no. 5 (2022): 315–321.
5. Gupta M, Mahajan VK, Mehta KS, et al. Zinc therapy in dermatology: a review. Dermatol Res Pract. 2014;2014:709152.
6. Klevay LM. Diets deficient in copper and zinc? Medical hypotheses. 1979; 5(12): 1323–1326.
7. Rayman MP. The importance of selenium to human health. Lancet. 2000; 356(9225):233-41.
8. Brenner S, Horwitz C. Possible nutrient mediators in psoriasis and seborrheic dermatitis. II. Nutrient mediators: essential fatty acids; vitamins A, E and D; vitamins B1, B2, B6, niacin and biotin; vitamin C selenium; zinc; iron. World Rev Nutr Diet. 1988;55:165-82.

9. Horn D, Barrientos A. Mitochondrial copper metabolism and delivery to cytochrome c oxidase. IUBMB Life. 2008; 60(7):421-9.
10. Schlecht U, Suresh S, Xu W, et al. A functional screen for copper homeostasis genes identifies a pharmacologically tractable cellular system. BMC Genomics. 2014; 15: 263.
11. E. A. Karabay and A. A. Çerman, “Serum Zinc Levels in Seborrheic Dermatitis: A Case-Control Study,” Turkish Journal of Medical Sciences 49, no. 5 (2019): 1503–1508.
12. Z. Hajheydari, M. Saeedi, and M. Hosseinzadeh, “The Relationship of Serum Selenium, Zinc, and Copper Levels With Seborrheic Dermatitis: A Case-Control Study,” Iranian Journal of Dermatology 22, no. 1 (2019): 7–12.
13. I. Jahan, M. R. Islam, M. R. Islam, et al., “Altered Serum Elements, Antioxidants, MDA, and Immunoglobulins Are Associated With an Increased Risk of Seborrheic Dermatitis,” Heliyon 7, no. 3 (2021): e06621.
14. A. Akbaş, F. Kılınç, S. Şener, and Y. Hayran, “Vitamin D Levels in Patients With Seborrheic Dermatitis,” Revista da Associação Médica Brasileira 69 (2023): e20230022.
15. H. C. Stephen, and A. S. Amindra, “Nutritional Disorders: Vitamins and Minerals”, in Mayo Clinic Gastroenterology and Hepatology Board Review, 6E, 6th ed., ed. H. C. Stephen (New York: Mayo Clinic Scientific Press, 2024), https://doi.org/10.1093/med/9780197679753.003.0009.
16. M. Alshaebi, L. Zahed, M. Osaylan, et al., “Association Between Diet and Seborrheic Dermatitis: A Case-Control Study,” Cureus 15, no. 11 (2023): e48782, https://doi.org/10.7759/cureus.48782.
17. Stefanaki I, Katsambas A. Therapeutic update on seborrheic dermatitis. Skin Therapy Lett. 2010; 15(5):1-4.
18. Bukvic MZ, Kralj M, Basta-Juzbasic A, et al. Seborrheic dermatitis: an update. Acta Dermatovenerolog Croatia. 2012; 20: 98-104.
19. Akinboro AO1, Mejiuni DA, Onayemi O, et al. Serum selenium and skin diseases among Nigerians with human immunodeficiency virus/acquired immune deficiency syndrome. HIV AIDS (Auckl). 2013; 5: 215–221.
20. Sampaio AL, Mameri AC, Vargas TJ, et al. An Bras Dermatol. 2011; 86(6):1061-71; quiz 1072-4.
21. E. Jablonska, M. Vinceti, Selenium and Human Health: Witnessing a Copernican Revolution? J. Environ. Sci. Health C. Environ. Carcinog. Ecotoxicol. Rev. 33 (3) (2015) 328-368.
22. L. Schomburg, The other view: the trace element selenium as a micronutrient in thyroid disease, diabetes, and beyond, Hormones (Athens) 19 (2020) 15-24.
23. M. Roman, P. Jitaru, C. Barbante, Selenium biochemistry and its role for human health, Metallomics 6 (1) (2014) 25-54.
24. B. Mistry, R.V. Patel, Y.S. Keum, D.H. Kim, Synthesis of N-Mannich bases of berberine linking piperazine moieties revealing anticancer and antioxidant effects, Saudi J. Biol. Sci. 24 (1) (2017) 36-44.
25. A.R. Vaughn, N. Foolad, M. Maarouf, K.A. Tran, V.Y. Shi, Micronutrients in Atopic Dermatitis: A Systematic Review, J. Altern. Complement. Med. 25 (6) (2019) 567-577.
26. M. Nazıroğlu, K. Yıldız, B. Tamtürk, I Erturan, M Flores-Arce, Selenium and psoriasis, Biol. Trace Elem. Res. 150 (1-3) (2012) 3-9.
27. Javanbakht M, Daneshpazhooh M, Chams-Davatchi C, et al. Serum selenium, zinc, and copper in early diagnosed patients with pemphigus vulgaris. Iran J Public Health. 2012; 41(5): 105–109.
28. Koohkan a., Pourpak Z., Safaralizadeh r., et al. Assessment of serum selenium level and whole blood selenium level in children with atopic dermatitis: A casecontrol study. Iran J Dermatol 2006; 9(2):143 -149.
29. Kaymak Y, Adisen e, Erhan M, et al. Zinc levels in patients with acne vulgaris. J Turk Acad Dermatol. 2007; 1(3): 71302a.
30. Hardy G, Menendez AM, Manzanares W. Trace element supplementation in parenteral nutrition: pharmacy, posology, and monitoring guidance. Nutrition. 2009; 25(11-12):1073-84.
31. Papet I, Meunier N, Béchereau F, et al. Effect of zinc supplementation on protein metabolism in late-middleaged men: the Zenith study. Nutrition. 2008; 24(2): 155-61.
32. Goldsmith LA, Katz SI, Gilchrest BA,et al (Eds). Fitzpatrick’s dermatology in general medicine. New York: McGraw- Hill; 2012.
33. Sehgal VN, Srivastava G. Traditional/Ayurvedic pharmacotherapy for skin diseases. Skinmed. 2010; 8(5):282-4.
34. Mrinal G, Vikram KM, Karaninder SM, et al. Zinc therapy in dermatology: a review. Dermatol Res Pract. 2014; 1-11.
35. Toyran M, Kaymak M, Vezir E, et al. Trace element levels in children with atopic dermatitis. J Investig Allergol Clin Immunol. 2012; 22: 341-344.
36. Hon KL, Wang SS, Hung EC, et al. Serum levels of heavy metals in childhood eczema and skin diseases: friends or foes. Pediatr Allergy Immunol. 2010; 21: 831-836.
37. Kashiri, Amine, and Negin Maghsoudloo. "Exploring the Impact of Vitamin D and Zinc Deficiencies on Seborrheic Dermatitis: A Comparative Study." Health Science Reports 7.12 (2024): e70283.
38. Kreft B, Wohlrab J, Fischer M, et al. Analysis of serum zinc level in patients with atopic dermatitis, psoriasis vulgaris and in probands with healthy skin. Hautarzt. 2000; 51(12): 931-4.
39. A. Hossein-nezhad, A. Spira, and M. F. Holick, “Influence of vitamin D status and vitamin D3 supplementation on genome wide expression of white blood cells: a randomized doubleblind clinical trial,” PLoS One, vol. 8, no. 3, e58725 pages, 2013.
40. D. D. Bikle, “Vitamin D and the skin: physiology and pathophysiology,” Reviews in Endocrine and Metabolic Disorders, vol. 13, no. 1, pp. 3–19, 2012.
41. D. D. Bikle and S. Pillai, “Vitamin D, calcium, and epidermal differentiation∗,” Endocrine Reviews, vol. 14, no. 1, pp. 3–19, 1993.
42. M. Sobhan, E. Khanlarzadeh, and M. Moradi Rozbhani, “Correlation Between Vitamin D Deficiency and Seborrheic Dermatitis in Patients Referred to the Dermatology Clinic of Sina Hospital, Hamadan, Iran,” Avicenna Journal of Clinical Medicine 28, no. 1 (2021): 20–27, http://doi.org/10.52547/ajcm.28.1.20.
43. J. Dimitrova, “Study of the Level of 25‐Hydroxyvitamin D in Patients With Seborrheic Dermatitis,” Scripta Scientifica Medica 45, no. 1 (2013): 75–78, http://doi.org/10.14748/ssm.v45i1.345.
44. Rahimi, Siavash, Negar Nemati, and Seyedeh Sareh Shafaei-Tonekaboni. "Serum Levels of 25‐Hydroxyvitamin D in Patients With Seborrheic Dermatitis: A Case‐Control Study." Dermatology research and practice 2021.1 (2021): 6623271.
45. D. Linder, J. Dreiher, A. Zampetti, F. Sampogna, and A. D. Cohen, “Seborrheic Dermatitis and Hypertension in Adults: A Cross‐Sectional Study,” Journal of the European Academy of Dermatology and Venereology 28, no. 11 (2014): 1450–1455.
46. F. Etgu, “Analysis of the Epidemiology, Coexisting Skin Diseases, and Variables Affecting Seborrheic Dermatitis Severity,” Medicine Science | International Medical Journal 12, no. 4 (2023): 994.
47. T. C. Wikramanayake, L. J. Borda, M. Miteva, and R. Paus, “Seborrheic Dermatitis—Looking Beyond Malassezia,” Experimental Dermatology 28, no. 9 (2019): 991–1001.
48. J. Nosewicz, N. Spaccarelli, K. M. Roberts, et al., “The Epidemiology, Impact, and Diagnosis of Micronutrient Nutritional Dermatoses. Part 2: B‐Complex Vitamins,” Journal of the American Academy of Dermatology 86, no. 2 (2022): 281–292.