Hulshof M M, Pavel S, Breedveld F C, Dijkmans B A, Vermeer B J
Department of Dermatology, University Hospital Leiden, The Netherlands.
Arch Dermatol. 1994 Oct;130(10):1290-3.
None of the commonly used drugs for the treatment of scleroderma appears to significantly influence the fibrotic stage of this disorder. Recently, a beneficial effect of the treatment with oral calcitriol (1,25 dihydroxyvitamin D3) in 10 patients with systemic sclerosis and four patients with morphea was described. This fact could be ascribed to the immunoregulatory effects of calcitriol observed in vitro and to inhibition of fibroblast growth. We treated three patients with extensive morphea with remarkable results.
Three patients with generalized morphea were treated with calcitriol in an oral daily dose of 0.50 to 0.75 microgram. After 3 to 7 months of treatment, the mobility of the joints improved and the skin extensibility increased. No adverse effects were observed. The improvement persisted after discontinuation of therapy during a follow-up period of 1 to 2 years.
Calcitriol showed a beneficial effect in generalized morphea during an open study. Double-blind, placebo-controlled trials are needed to assess its therapeutic value.
治疗硬皮病的常用药物似乎均未对该疾病的纤维化阶段产生显著影响。最近，有报道称口服骨化三醇（1,25-二羟维生素D3）治疗10例系统性硬化症患者和4例局限性硬皮病患者取得了有益效果。这一事实可能归因于体外观察到的骨化三醇的免疫调节作用和成纤维细胞生长的抑制作用。我们用骨化三醇治疗了3例广泛性局限性硬皮病患者，效果显著。
3例泛发性局限性硬皮病患者接受骨化三醇治疗，口服剂量为每日0.50至0.75微克。治疗3至7个月后，关节活动度改善，皮肤延展性增加。未观察到不良反应。在停药后的1至2年随访期内，改善情况持续存在。
在一项开放性研究中，骨化三醇对泛发性局限性硬皮病显示出有益效果。需要进行双盲、安慰剂对照试验来评估其治疗价值。
