Vitamin D Biomarkers Associated with Abnormal Scar Formation in Pediatric Burn Patients

Abstract

Background: Hypovitaminosis D following burn injury has been reported in patients who develop scars. This retrospective study examined associations between vitamin D levels and abnormal scar formation in patients supplemented with different vitamin D regimens.

Materials and Methods: In a previous prospective study, fifty children with >30% total body surface area burns were randomized to daily inpatient supplementation with ergocalciferol (vitamin D2), cholecalciferol (vitamin D3), or placebo, which was administered in addition to a standardized nutritional protocol for acute care of burned children. The current retrospective study compared demographic and inpatient data from these patients, including biomarkers of vitamin D status, with outcomes related to abnormal scar development. Keloid or hypertrophic scar formation was determined from chart review, physician diagnosis, and photographic documentation.

Results: A trend was observed for reduced blood levels of cholecalciferol and calcidiol at the time of hospital discharge in patients who developed keloids or hypertrophic scars. There was no association between PTH and calcitonin levels and abnormal scar formation.

Conclusion: Reduced vitamin D levels in pediatric burn patients may be a contributing factor in development of keloids and hypertrophic scars. Further investigation is needed to confirm these findings, establish the mechanism of this relationship, and develop clinical guidelines for vitamin D supplementation in pediatric burn patients.