Mai Michelle, Lazaridou Ingrid, Mirza Fatima N, Costenbader Karen H, Qureshi Abrar A, Cho Eunyoung
Division of Dermatology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA.
Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Skin Health Dis. 2025 Apr 22;5(3):178-190. doi: 10.1093/skinhd/vzaf010. eCollection 2025 Jun.
Psoriasis is a prevalent skin disorder affecting approximately 2-3% of the population in the USA. Its complex and varied presentations necessitate a diverse range of available therapeutic options. While topical corticosteroid therapy is conventionally employed as first-line treatment, long-term usage increases the risk of adverse events, prompting the consideration of alternatives including steroid-sparing agents such as vitamin D. In this article, we review literature from topical and oral vitamin D trials for the treatment of psoriasis. Topically, vitamin D analogues have been well established as an effective long-term treatment, particularly when used in combination with other therapies. Moreover, combination therapy with immunomodulators such as apremilast and methotrexate has shown promise as well. Conversely, oral vitamin D supplementation trials have yielded more inconsistent results, with some supplementation clinical trials showing significant psoriasis resolution and others showing no significant changes in psoriasis outcome. Vitamin D deficiency status, seasonal variation and body mass index were factors that may have modulated the therapeutic effect of vitamin D supplementation. Further study combining vitamin D supplementation with pre-existing treatments may also augment the effect of monotherapy. Studies on the synergistic effects of combination therapies with oral vitamin D or the development of foam-based or microneedle drug delivery systems may be promising next steps.
银屑病是一种常见的皮肤疾病，在美国约2%-3%的人口中受到影响。其复杂多样的表现需要多种可用的治疗选择。虽然局部皮质类固醇疗法传统上被用作一线治疗，但长期使用会增加不良事件的风险，促使人们考虑包括维生素D等类固醇节省剂在内的替代方案。在本文中，我们回顾了局部和口服维生素D治疗银屑病试验的文献。在局部治疗方面，维生素D类似物已被确认为一种有效的长期治疗方法，特别是与其他疗法联合使用时。此外，与阿普司特和甲氨蝶呤等免疫调节剂的联合治疗也显示出前景。相反，口服维生素D补充试验的结果则更为不一致，一些补充临床试验显示银屑病有显著改善，而另一些则显示银屑病结局无显著变化。维生素D缺乏状态、季节变化和体重指数可能是调节维生素D补充治疗效果的因素。将维生素D补充与现有治疗相结合的进一步研究也可能增强单一疗法的效果。关于口服维生素D联合疗法的协同作用或基于泡沫或微针给药系统开发的研究可能是有前景的下一步。
