Boisseau-Garsaud A M, Legrain V, Hehunstre J P, Maleville J, Taïeb A
Service de Dermatologie, Hôpital Pellegrin-Enfants, Bordeaux.
Ann Dermatol Venereol. 1993;120(10):669-74.
Vitamin D topical analogues are now considered an excellent adjunct to the therapy of psoriasis. Systemic vitamin D3 treatment has been used occasionally, especially in case of associated hypocalcemia. We report five patients (aged 6, 16, 36, 58 and 79 years) successfully treated with vitamin D3 per os. Four had erythrodermic and/or pustulous psoriasis, and two of these had concomitant hypocalcemia. The fifth patient was a girl with pseudohypoparathyroidism and psoriasis vulgaris. The association of hypocalcemia and severe psoriasis is classical and was an incentive to try vitamin D treatment. A review of the literature showed that vitamin D can also be reported as a treatment of psoriasis vulgaris. Hypercalciuria and hypercalcemia are limiting risks. However calcium toxicity seems to be minor when vitamin D is given once a day at bedtime in doses lower than 2 micrograms/24 h. Double blind studies should be performed to determine the real efficacy of this treatment.
维生素D外用类似物现在被认为是银屑病治疗的一种优秀辅助手段。系统性维生素D3治疗偶尔会被使用,特别是在伴有低钙血症的情况下。我们报告了5例经口服维生素D3成功治疗的患者(年龄分别为6岁、16岁、36岁、58岁和79岁)。其中4例患有红皮病型和/或脓疱型银屑病,其中2例伴有低钙血症。第5例患者是一名患有假性甲状旁腺功能减退和寻常型银屑病的女孩。低钙血症与严重银屑病的关联很典型,这促使我们尝试维生素D治疗。文献综述表明,维生素D也可作为寻常型银屑病的一种治疗方法。高钙尿症和高钙血症是限制风险。然而,当维生素D在睡前每天一次以低于2微克/24小时的剂量给药时,钙毒性似乎较小。应进行双盲研究以确定这种治疗的实际疗效。