Title : Treatment of vitiligo patients with high doses of oral vitamin D3 combined with melanocyte stimulation and pigment cell transplantation is safe and efficacious
Abstract:
Vitiligo is a complex autoimmune skin disease resulting in varying patterns and degrees of depigmentation. The genetic and etiologic background are thought to be multifactorial. As in other autoimmune diseases regulation of immune dysfunctions through vitamin D seems to be important also in vitiligo. A recent meta-analysis revealed that vitamin D receptor (VDR) Apal polymorphism increased the susceptibility risk of vitiligo. Our own work demonstrates a correlation of BsmI VDR polymorphism in > 60 % of all vitiligo patients. We and others have shown a positive correlation between serum 25(OH)D deficiency and the incidence of vitiligo. Using these pathogenetic facts in our Vitiligo Center, we are prescribing high doses of oral vitamin D3 according to Finamor DC et al. (Dermatoendocrinol 2013; 5:222-34). Patients are receiving oral vitamin D3 supplements of 20.000 to 60,000 IU once daily according to their body weight and their parathormone level at baseline for at least six months in association with a low-calcium diet (avoiding dairy products and calcium-enriched foods like oat, rice or soya “milk”) and sufficient hydration (minimum 2.5 L daily). As published before, also in our sample serum creatinine and calcium does not change significantly and urinary calcium excretion only increases within the normal range. Combining oral vitamin D3 with subsequent melanocyte stimulation using UVB 311 nm irradiation stabilization of vitiligo can be reached in > 95 % of all patients. Pigment cell transplantation using non-cultured melanocyte cell suspensions is the further step in our treatment protocol for selected patients.
The presentation will show that our therapeutic strategy for vitiligo using oral high-dose vitamin D3 therapy is very effective and safe for vitiligo patients.
