Oral vitamin D versus acitretin in congenital non‐syndromic ichthyosis: double blinded, randomized controlled trial

Abstract

Background: Vitamin D has emerged as a promising treatment for congenital ichthyosis for which no comparative studies exist. Methodology:In this randomized, double-blinded study, patients with congenital ichthyosis received either Vitamin D 2000 IU/day (group A) or acitretin 0.5 mg/kg/day (group B) for 24 weeks. The primary outcome was improvement in the Visual Index for Ichthyosis Severity (VIIS) and Ichthyosis Area Severity Index (IASI). Secondary outcomes included Ichthyosis Quality of Life Index-32 (IQoL-32), mRNA expression of RORγt and IL-17 and adverse events.Results: Twenty-four patients completed the study. Group A (n = 11) showed a significant decrease in VIIS (p = 0.023) and IASI (p = 0.026) at 12 but not 24 weeks. Group B (n = 13) showed a significant decrease in IASI at 24 weeks only (p = 0.016). The IQoL-32 improved over 24 weeks in both groups. A significant decrease in the mRNA expression of RORγt (p = 0.048) and IL-17 (p = 0.023) was seen only in group A. There was no significant difference between the two treatment arms in terms of VIIS, IASI and IQol-32 at 12 and 24 weeks. No serious adverse events were observed. Conclusion:Vitamin D maybe an alternative to acitretin in the treatment of congenital ichthyosis where it reduces the expression of RORγt and IL-17.

Management of Harlequin Ichthyosis: A Brief Review of the Recent Literature

“…Therefore, despite the possibilities of retinoids’ protective effects on ischemic injury, there are studies that do not suggest retinoid therapy in infants and recommend not to preclude them to a surgical intervention [ 38 ]. A recent novel randomized controlled trial study proposed vitamin D intake as a promising alternative for managing congenital ichthyosis in comparison to acitretin [ 46 ]. In 2021, the scientific community published a consensus of recommendations regarding the safety of the topical and systemic administration of retinoids [ 47 ].…”

Osteoporosis and bone health in pediatric patients with epidermolysis bullosa: A scoping review

“…36 Highdose vitamin D treatment has been therapeutic in ichthyosis, 37 with improvement in quality of life comparable to treatment with acitretin. 38 In inflammatory skin conditions such as atopic dermatitis and psoriasis, vitamin D is suggested to attenuate acute inflammation through modulation or inhibition of inflammatory cytokines, facilitating skin recovery. 39 Given Vitamin D's additional roles of keratinocyte differentiation and skin barrier formation, along with its impact on other skin conditions, further studies of the role of vitamin D in EB skin are warranted.…”

Harlequin ichthyosis newborn: A case report

“…4 In a novel randomized controlled trial study, vitamin D intake was proposed as a promising alternative for managing congenital ichthyosis compared to acitretin. 43 However, despite the protective effects of retinoids on ischemic injury, some studies do not suggest retinoid therapy in infants (and recommend not to preclude them to a surgical intervention). 44 Tsivilika et al suggested that, although applying topical retinoids have been suggested as an alternative to surgery, no satisfactory results have been seen in most cases.…”