Topical application of 1,25-dihydroxyvitamin D3 (calcitriol) is an effective and reliable therapy to cure skin lesions in psoriatic children

Abstract

We studied, in vivo, the effects of a calcitriol-containing ointment (3 micrograms of calcitriol per gram of petrolatum) topically applied on skin lesions in children affected by psoriasis vulgaris. Each patient was instructed to apply the ointment, about 1 g once a day at bedtime followed by occlusive dressing with plastic wrap, on one-side lesion (treated) and petrolatum alone on the equivalent controlateral site (placebo) (total weekly dose of calcitriol: approximately 21 micrograms/patient). After 4 weeks of topical treatment all children showed a complete clearing of their skin lesions on the treated side, without appreciable changes on the placebo side. Serum ionised calcium, calcium and calcitriol levels or urinary calcium excretion did not vary significantly throughout the period of therapy. These findings suggest that topical calcitriol may be an effective and safe alternative therapy for psoriasis in children.

Efficacy and safety of treatments for childhood psoriasis: A systematic literature review

“…No adverse events were reported in two studies. 19,28 The two remaining studies did not mention side effects. 24,26 Conclusion Grade A Number of patients treated with calcipotriene: 155.…”

“…[18][19][20][21][22][23][24][25][26][27] One case report 27 was excluded because of an unclear diagnosis.…”

“…Several other studies showed a positive effect of calcipotriene treatment on psoriatic lesions with an estimated outcome measure of clearance or marked improvement in at least 65% of cases. [21][22][23][24][25][26] Calcitriol ointment (3 g/g) was applied in a randomized double-blind study 19 (LOE 2b), showing a residual mild erythema in all 10 patients. Perez et al 20 performed a study with calcitriol of which the first part was placebo controlled (LOE 2b) and the second part was open label (LOE 4).…”

Therapy of psoriasis in childhood and adolescence ‐ a German expert consensus

“…For topical therapy of psoriasis in adults with analogs of vitamin D 3 currently three different derivatives are available, but only with age restrictions for children (Table 3). This is not based on pharmacological grounds, as safety studies detected no serious side effects in children with correct use [21, 22].…”

Long-term safety of topical calcitriol 3 mug g-1 ointment

“…It is well known that the skin plays an important role in vitamin D 3 metabolism and that the endogenously produced, hormonally active, metabolite of vitamin D 3 , 1,25‐(OH) 2 D 3 or calcitriol, is essential for the maintenance of calcium homeostasis. Calcitriol and other vitamin D 3 derivatives have been shown to have antipsoriatic potential and, in recent years, several reports on the efficacy of topical calcitriol have been published 1 –4 . These studies have focused on short‐term treatment regimens with calcitriol ointment.…”