cholecalciferol and Nail-Diseases

Topics: Administration, Topical; Adrenal Cortex Hormones; Cholecalciferol; Diagnosis, Differential; Drug Combinations; General Practice; Humans; Nail Diseases; Psoriasis; Skin Care

The palmoplantar keratodermas (PPKs) are a heterogeneous group of disorders of cornification affecting the palms and soles. Of late, a number of rare, recessive PPKs such as odonto-onycho-dermal dysplasia have been elucidated. Surprisingly, these results indicate that correct palmoplantar keratinization depends on intact Wingless (WNT) signalling. WNT was originally discovered in the fruit fly where it is required for wing morphogenesis. This ancient signalling pathway is now emerging as a master regulator of differentiation in a variety of tissues, including the intestine and the hair follicle. It is also becoming increasingly clear that deregulation of WNT signalling is involved in neoplasia. Thus, a single pathway unites several seemingly disparate processes and disorders. The keratodermas are emerging as model systems in which to study WNT signalling. Moreover, as agents that are in the dermatological arsenal can modulate WNT signalling, some insight into its workings is of importance to the practicing dermatologist. In this review, I outline how WNT signalling is involved in epidermal differentiation and skin cancer and what these new insights mean for everyday dermatology.

Topics: Cholecalciferol; Forecasting; Hand Dermatoses; Humans; Keratoderma, Palmoplantar; Nail Diseases; Skin Neoplasms; Wnt Proteins

Cutaneous warts are particularly difficult to treat with conventional treatment on sites such as the palms, soles, and periungual region. Immunotherapy boosts the host immune response and helps clear warts with less chance of recurrence. Vitamin D plays an important role in proliferation and differentiation of keratinocytes. The aim of this observational study was to study the efficacy and safety of intralesional vitamin D immunotherapy in the treatment of recalcitrant palmoplantar and periungual warts. Patients who had palmoplantar and periungual warts for more than 6 months and were non-responsive to at least two conventional treatment modalities were selected for the study. A maximum of four warts were injected with 0.2 mL of lignocaine (20 mg/mL), followed by intralesional injection of 0.2-0.5 mL of vitamin D3 (15 mg/mL), every 2 weeks for a maximum of four sessions. Response was assessed based on the reduction in the number of warts. A total of 63 patients were included in the study. The mean number of intralesional vitamin D3 injections required for complete clearance was 3.05±0.83 (mean ± Standard Deviation). Complete response was observed in 56 (88.9%) patients. Maximum clearance was observed in periungual warts (92.9%), followed by palmar warts (90.0%) and plantar warts (86.2%). The most common adverse effect was pain during injection (100.0%) and local swelling (25.4%). Two patients developed recurrence during follow-up. Immunotherapy with vitamin D3 appears to be an effective, inexpensive, and safe treatment in recalcitrant palmoplantar and periungual warts.

Topics: Adolescent; Adult; Cholecalciferol; Female; Humans; Injections, Intralesional; Male; Middle Aged; Nail Diseases; Prospective Studies; Treatment Outcome; Vitamins; Warts; Young Adult

Topics: Cholecalciferol; Humans; Immunotherapy; Injections, Intralesional; Nail Diseases; Vitamins; Warts

Topics: Administration, Topical; Adrenal Cortex Hormones; Biological Products; Cholecalciferol; Combined Modality Therapy; Esthetics; Humans; Medication Adherence; Nail Diseases; Psoriasis