Associations among plasma vitamin C, epidermal ceramide and clinical severity of atopic dermatitis

Jihye Shin, You Jin Kim, Oran Kwon, Nack In Kim, Yunhi Cho

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


BACKGROUND/OBJECTIVES: Atopic dermatitis (AD), a chronic inflammatory skin disease, is accompanied by disruption of the epidermal lipid barrier, of which ceramide (Cer) is the major component. Recently it was reported that vitamin C is essential for de novo synthesis of Cer in the epidermis and that the level of vitamin C in plasma is decreased in AD. The objective of this study was to determine the associations among clinical severity, vitamin C in either plasma or epidermis, and Cer in the epidermis of patients with AD. SUBJECTS/METHODS: A total of 17 patients (11 male and 6 female) aged 20-42 years were enrolled. The clinical severity of AD was assessed according to the SCORAD (SCORing Atopic Dermatitis) system. Levels of vitamin C were determined in plasma and biopsies of lesional epidermis. Levels of epidermal lipids, including Cer, were determined from tape-stripped lesional epidermis. RESULTS: The clinical severity of patients ranged between 0.1 and 45 (mild to severe AD) based on the SCORAD system. As the SCORAD score increased, the level of vitamin C in the plasma, but not in the epidermis, decreased, and levels of total Cer and Cer2, the major Cer species in the epidermis, also decreased. There was also a positive association between level of vitamin C in the plasma and level of total Cer in the epidermis. However, levels of epidermal total lipids including triglyceride, cholesterol, and free fatty acid (FFA) were not associated with either SCORAD score or level of vitamin C in the plasma of all subjects. CONCLUSIONS: As the clinical severity of AD increased, level of vitamin C in the plasma and level of epidermal Cer decreased, and there was a positive association between these two parameters, implying associations among plasma vitamin C, epidermal Cer, and the clinical severity of AD.

Original languageEnglish
Pages (from-to)398-403
Number of pages6
JournalNutrition Research and Practice
Issue number4
StatePublished - Aug 2016

Bibliographical note

Funding Information:
This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2012R1A1A3005669).

Publisher Copyright:
© 2016 The Korean Nutrition Society and the Korean Society of Community Nutrition.


  • Atopic dermatitis
  • Ceramide
  • Clinical severity
  • Vitamin C


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