1-alpha-24-dihydroxyvitamin-d3 and Keratosis

Topical tacalcitol (1alpha,24-dihydroxyvitamin D3) has been demonstrated to produce beneficial clinical effects on epidermo-hyperproliferative disorders such as psoriasis and pityriasis rubra pilaris. However, the efficacy of the agent has not been elucidated in retentive hyperkeratotic disorders.. The object of the study was to assess the clinical efficacy of topical tacalcitol against ichthyoses with retentive hyperkeratosis; X-linked ichthyosis (XLI), ichthyosis vulgaris (IV), and acquired ichthyosis (AI).. Tacalcitol was topically applied on 9 patients with the retention ichthyoses, using a single-blinded, bilaterally paired approach with right-left comparison of tacalcitol and the base.. Clinical improvement obtained by topical tacalcitol exclusively was not superior to that of the vehicle alone in any of the ichthyotic patients.. Topical tacalcitol therapy was ineffective against ichthyoses without epidermal hyperproliferation.

Topics: Administration, Topical; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Child; Dermatologic Agents; Dihydroxycholecalciferols; Female; Humans; Ichthyosis; Ichthyosis Vulgaris; Ichthyosis, X-Linked; Keratosis; Male; Middle Aged

Topics: Administration, Topical; Biopsy; Breast Diseases; Dermatologic Agents; Dihydroxycholecalciferols; Female; Humans; Keratosis; Keratosis, Seborrheic; Nipples; Remission Induction; Treatment Outcome; Young Adult

Keratosis lichenoides chronica (KLC) is a rare chronic progressive cutaneous disease that is part of the heterogeneous group of lichenoid dermatoses. The typical clinical presentation is characterized by lichenoid hyperkeratotic papules and nodules arranged in a linear and reticular pattern on the trunk and extremities. Our case confirms the existence of a vascular variant of KLC. There is no consensus about its treatment, since it is refractory to many different treatment modalities. We report the effectiveness of acitretin in KLC in combination with tacalcitol. KLC is of unknown aetiology, but is perhaps associated with systemic diseases, most importantly glomerulonephritis and lymphoma. This is the second case associated with hypothyroidism.

Topics: Acitretin; Chronic Disease; Dermatologic Agents; Dihydroxycholecalciferols; Drug Therapy, Combination; Female; Humans; Hypothyroidism; Keratolytic Agents; Keratosis; Lichenoid Eruptions; Middle Aged; Skin Diseases, Vascular

Hyperkeratosis lenticularis perstans (HLP) or Flegel's disease is a rare dermatosis characterized by asymptomatic hyperkeratotic papules predominantly located on the lower extremities. Lesional and non-lesional epidermis samples were studied by light- and electron-microscopic examination. The main ultrastructural finding was the presence of structurally altered Odland bodies/membrane-coating granules. Different therapeutic options for HLP have been reported, but none of the treatments was shown to be consistently effective. Here, we report on a patient with Flegel's disease who did respond to topical 5-fluorouracil, whereas topical vitamin D(3) synthetics were ineffective.

Topics: Calcitriol; Dermatologic Agents; Dihydroxycholecalciferols; Female; Humans; Keratosis; Leg Dermatoses; Microscopy, Electron; Middle Aged; Skin; Treatment Outcome