A pilot study assessing the effect of prolonged administration of high daily doses of vitamin D on the clinical course of vitiligo and psoriasis

Abstract

Autoimmunity has been associated with vitamin D deficiency and resistance, with gene polymorphisms related to vitamin D metabolism frequently described in affected patients. High doses of vitamin D3 may conceivably compensate for inherited resistance to its biological effects. This study aimed to assess the efficacy and safety of prolonged high-dose vitamin D3 treatment of patients with psoriasis and vitiligo. Nine patients with psoriasis and 16 patients with vitiligo received vitamin D3 35,000 IU once daily for six months in association with a low-calcium diet (avoiding dairy products and calcium-enriched foods like oat, rice or soya “milk”) and hydration (minimum 2.5 L daily). All psoriasis patients were scored according to “Psoriasis Area and Severity Index” (PASI) at baseline and after treatment. Evaluation of clinical response of vitiligo patients required a quartile grading scale. All patients presented low vitamin D status (serum 25(OH)D3 ≤ 30 ng/mL) at baseline. After treatment 25(OH)D3 levels significantly increased (from 14.9 ± 7.4 to 106.3 ± 31.9 ng/mL and from 18.4 ± 8.9 to 132.5 ± 37.0 ng/mL) and PTH levels significantly decreased (from 57.8 ± 16.7 to 28.9 ± 8.2 pg/mL and from 55.3 ± 25.0 to 25.4 ± 10.7 pg/mL) in patients with psoriasis and vitiligo respectively. PTH and 25(OH)D3 serum concentrations correlated inversely. The PASI score significantly improved in all nine patients with psoriasis. Fourteen of 16 patients with vitiligo had 25–75% repigmentation. Serum urea, creatinine and calcium (total and ionized) did not change and urinary calcium excretion increased within the normal range. High-dose vitamin D3 therapy may be effective and safe for vitiligo and psoriasis patients.

A case control study of vitamin D levels in patients with vitiligo

“…Similar results were obtained in a study by Finamor et al as well as Takczi et al 9,11 However the majority of patients in other studies had a mean age below 35. [6][7][8][12][13][14][15][16][17][18][19][20] This may reflect certain social attitudes towards the disease i.e.…”

Vitamin D status in patients with psoriasis

“…Deficiency and insufficiency of vitamin D were found in many immune-mediated and neoplastic diseases. So, the role of vitamin D in the pathogenesis of psoriasis, as well as in rheumatoid arthritis, multiple sclerosis, systemic lupus, and inflammatory bowel diseases can be speculated (4)(5)(6). The assessment of the blood level of 25-hydroxyvi-Stoyan Pavlov, Irina Ivanova, Daniela Gerova tamin D, 25(OH)D, which is a major circulating metabolite of vitamin D is an accepted test for a vitamin D status (7).…”

Assessment of Dietary Supplementation in the Treatment of Vitiligo

“…Sixteen vitiligo patients were treated with 35,000 IU of 25-hydroxyvitamin D daily for six months, and as expected, measured serum levels of vitamin D increased significantly throughout the study. Additionally, eleven out of the sixteen patients with vitiligo experienced 25-75% repigmentation during this time period [43]. Increases in serum vitamin D levels were associated with corresponding repigmentation.…”

“…Increases in serum vitamin D levels were associated with corresponding repigmentation. This study raises the possibility of vitamin D supplementation as a treatment option for patients with vitiligo [43]. However, further studies are needed for a more complete understanding of the mechanism and clinical utility of vitamin D supplementation, as this topic is controversial and in need of further evidence.…”