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Randomized double‐blinded placebo‐controlled intra‐individual trial on topical treatment with a 1,25‐dihydroxyvitamin D 3 analogue in polymorphic light eruption
Author(s) -
GruberWackernagel A.,
Bambach I.,
Legat F.J.,
Hofer A.,
Byrne S.N.,
Quehenberger F.,
Wolf P.
Publication year - 2011
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.2011.10333.x
Subject(s) - calcipotriol , medicine , placebo , calcitriol , photodermatosis , confidence interval , sunburn , visual analogue scale , randomized controlled trial , vitamin d and neurology , gastroenterology , dermatology , surgery , psoriasis , pathology , dna , genetics , alternative medicine , xeroderma pigmentosum , dna damage , biology
Summary Background Polymorphic light eruption (PLE) is a very frequent photodermatosis whose pathogenesis may involve resistance to ultraviolet (UV)‐induced immune suppression. Similar to UV radiation, calcitriol (1,25‐dihydroxyvitamin D 3 ) and its analogues such as calcipotriol have been shown to exhibit immunosuppressive properties. Objectives We performed a randomized double‐blinded placebo‐controlled intraindividual half‐body trial (NCT00871052) to investigate the preventive effect of a calcipotriol‐containing cream in PLE. Methods Thirteen patients with PLE (10 women, three men; mean age 37 years) pretreated their skin on two symmetrically located test fields with calcipotriol or placebo cream twice daily for 7 days before the start of photoprovocation testing with solar‐simulated UV radiation. We established a specific PLE test score [AA + SI + 0·4 P (range 0–12), where AA is affected area score (range 0–4), SI is skin infiltration score (range 0–4) and P is pruritus score on a visual analogue scale (range 0–10)] to quantify PLE severity. Results Photoprovocation led to PLE lesions in 12/13 (92%) patients. As shown by the PLE test score, compared with placebo calcipotrial pretreatment significantly reduced PLE symptoms in average by 32% (95% confidence interval 21–44%; P = 0·0022, exact Wilcoxon signed‐rank test) throughout the observation period starting at 48 h until 144 h after the first photoprovocation exposure. At 48, 72 and 144 h calcipotriol pretreatment resulted in a lower PLE test score in 7 (58%), 9 (75%) and 10 (83%) of the 12 cases, respectively. Considering all time points together, calcipotriol diminished the PLE test score in all 12 photoprovocable patients ( P = 0·0005; Wilcoxon signed‐rank test). Conclusions These results suggest a potential therapeutic benefit of topical 1,25‐dihydroxyvitamin D 3 analogues as prophylactic treatment in patients with PLE.