Jung Kyung Eun, Woo Yu Ri, Lee Joong Sun, Shin Jong Ho, Jeong Jin Uk, Koo Dae Won, Bang Ki Tae
Department of Dermatology, School of Medicine, Eulji University Hospital, Daejeon, Korea.
Department of Internal Medicine (Nephrology), School of Medicine, Eulji University Hospital, Daejeon, Korea.
J Dermatol. 2015 Aug;42(8):800-3. doi: 10.1111/1346-8138.12895. Epub 2015 Apr 28.
Chronic kidney disease-associated pruritus (CKD-aP) is a troublesome symptom in patients with end-stage renal disease (ESRD). Recently, vitamin D deficiency has been known to be one of the possible etiologic factors in CKD-aP. However, limited data is available on whether topical vitamin D treatment is effective for relieving CKD-aP. Therefore, the purpose of this study is to evaluate the effectiveness of topically vitamin D for CKD-aP. Twenty-three patients with CKD-aP were enrolled in a single center, open-label study. Patients were instructed to apply a topical vitamin D (calcipotriol) agent (Daivonex solution; LEO Pharma) or vehicle solution twice daily for a month. We assessed the efficacy and safety of topical vitamin D on CKD-aP using clinical and dermoscopic photographs, and questionnaires including the validated modified pruritus assessment score (VMPAS) and visual analog scale (VAS) every 2 weeks. Dry dermoscopic findings showed significant improvement of scale (dryness) on the skin of topical vitamin D-treated patients compared with those of the vehicle group. Both VMPAS and VAS were significantly decreased after 2 and 4 weeks of the topical vitamin D treatment compared with the vehicle, respectively (P < 0.05). No significant side-effects were observed. Topical vitamin D may be one of the safe and effective therapeutic candidates for CKD-aP.
慢性肾脏病相关性瘙痒（CKD-aP）是终末期肾病（ESRD）患者中一种令人困扰的症状。最近，维生素D缺乏已被认为是CKD-aP可能的病因之一。然而，关于局部应用维生素D治疗缓解CKD-aP是否有效，可用数据有限。因此，本研究的目的是评估局部应用维生素D治疗CKD-aP的有效性。23例CKD-aP患者参与了一项单中心、开放标签研究。患者被指示每天两次外用维生素D（卡泊三醇）制剂（达力士溶液；LEO制药公司）或赋形剂溶液，持续一个月。我们每2周使用临床和皮肤镜照片以及问卷，包括经过验证的改良瘙痒评估评分（VMPAS）和视觉模拟量表（VAS），评估局部应用维生素D治疗CKD-aP的疗效和安全性。皮肤镜下干燥表现显示，与赋形剂组相比，局部应用维生素D治疗的患者皮肤鳞屑（干燥）有显著改善。与赋形剂相比，局部应用维生素D治疗2周和4周后，VMPAS和VAS均显著降低（P<0.05）。未观察到明显的副作用。局部应用维生素D可能是治疗CKD-aP的安全有效的候选疗法之一。
