AUTHOR=Karampinis Emmanouil , Goudouras George , Ntavari Niki , Bogdanos Dimitrios Petrou , Roussaki-Schulze Angeliki-Victoria , Zafiriou Efterpi 

TITLE=Serum vitamin D levels can be predictive of psoriasis flares up after COVID-19 vaccination: a retrospective case control study

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1203426

DOI=10.3389/fmed.2023.1203426

ISSN=2296-858X

ABSTRACT=Many patients with chronic inflammatory dermatosis such as psoriasis usually ask about the safety of COVID-19 vaccination and if itwould affect the course of their disease. Indeed, many case reports, case series and clinical studies, reporting psoriasis exacerbation following vaccination against COVID-19, were published during the pandemic. Also, many questions arise regarding the existence of exacerbating factors of these flare ups, including environmental triggers such as the insufficiency of vitamin D levels. This is a retrospective study that measures alterations in psoriasis activity and severity index (PASI) not exceeding two weeks after the first and second dose of COVID-19 vaccinations in the reported cases and assesses whether such changes have any association with patients’ vitamin D levels. We retrospectively reviewed the case records of all patients with a documented flare up after COVID-19 vaccination in our department as well as those who did not, during a year. Amongst them, we found 40 psoriasis patients that had reported vitamin D levels in the form of 25-hydroxy-vitamin D within 3 weeks after vaccination, including 23 with exacerbation and 17 without exacerbation. Performing χ2 and t-test controls for psoriasis patients with and without flare-ups, a statistically significant dependence emerged in the seasons of summer (χ2 (1) =5.507, p=0.019), spring (χ2 (1) =11.429, p=0.001) and in the categories of vitamin D (χ2 (2)=7.932, p=0.019), while the mean value of vitamin D for psoriasis patients who did not have exacerbation (31.14± 6.67  ng/mL) is statistically higher (t (38) =3.655, p=0.001) than the corresponding value of psoriasis patients who had an exacerbation (23.43±6.49 ng/mL). This study indicates that psoriasis patients with insufficient (21-29 ng/mL) or inadequate (<20 ng/mL) levels of vitamin D are more prone to postvaccination aggravation of the disease while vaccination in summer, a period with the most extent photo-exposition, can be a protective factor.