Vitamin D status in psoriasis patients during different treatments with phototherapy.
BACKGROUND
Phototherapy (broadband UVB (BUVB), narrowband UVB (NBUVB) and heliotherapy) is commonly used treatment modalities for widespread psoriasis. Vitamin D3, cholecalciferol, is produced in the epidermis by ultraviolet radiation (290-315 nm) of 7-dehydrocholesterol. 25-hydroxyvitamin D [25(OH)D], and 1,25-dihydroxyvitamin D [1,25(OH)(2)D] are the major circulating metabolites. Sun exposure is the strongest factor influencing 25(OH)D. The similar wavelength spectrum of UVB responsible for D vitamin synthesis (BUVB, 280-315 nm) has been successfully used for years to treat psoriasis.


OBJECTIVE
The aim was: (1) To increase the knowledge about the effects of phototherapy on vitamin D production during treatment of psoriasis. (2) To examine if there were differences between the effect of BUVB, NBUVB and heliotherapy on vitamin D synthesis in psoriasis patients.


METHODS
Serum concentrations of 25(OH)D, 1,25(OH)(2)D, PTH, calcium and creatinine, measured before and after phototherapy in white Caucasian patients with moderate to severe active plaque psoriasis, were aggregated from three studies.


RESULTS
Psoriasis improved in all patients, with a reduction in PASI ((Psoriasis Area and Severity Index) score of about 75% on all regimes. Serum 25(OH)D increased and PTH decreased after the phototherapy. The increase in 25(OH)D was higher in the BUVB treated patients compared with NBUVB. There was no correlation between the dose of UVB and the increase of 25(OH)D.


CONCLUSIONS
UVB and heliotherapy improved the psoriasis score, increased the serum 25(OH)D levels and reduced the serum PTH concentrations. Vitamin D production in psoriasis patients increased less with NBUVB than with BUVB phototherapy.
Osmancevic
Amra
A
Dept of Dermatology, Sahlgrenska University Hospital, Gothenburg, Sweden. Amra.Osmancevic@vgregion.se
Landin-Wilhelmsen
Kerstin
K
Larkö
Olle
O
Krogstad
Anne Lene
AL
D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D006370:Heliotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010789:Phototherapy; D011565:Psoriasis / Q000628:therapy*; D014466:Ultraviolet Rays; D014467:Ultraviolet Therapy; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood / Q000378:metabolism*
D010281:Parathyroid Hormone; D014807:Vitamin D; C097949:1,25-dihydroxyvitamin D; C104450:25-hydroxyvitamin D; D003404:Creatinine; D002118:Calcium