Treatment of alopecia totalis/universalis/focalis with vitamin D and analogs:Three case reports and a literature review  

作　　者：Dimitrios T Papadimitriou Christina Bothou Eleni Dermitzaki Alexios Alexopoulos George Mastorakos 

机构地区：[1]Department of Pediatric-Adolescent Endocrinology and Diabetes,Athens Medical Center,Athens 15125,Greece [2]Endocrine Unit,Aretaieion University Hospital,Athens 11528,Greece [3]Department of Endocrinology,Diabetology and Clinical Nutrition,University Hospital Zurich(USZ),University of Zurich(UZH),CH-8091 Zurich,Switzerland [4]Special Unit of Dermatology,First Department of Pediatrics,National and Kapodistrian University of Athens Medical School,Agia Sofia Children's Hospital,Athens 11527,Greece

出　　处：《World Journal of Clinical Pediatrics》2021年第6期192-199,共8页世界临床儿科杂志

摘　　要：BACKGROUND Alopecia areata(AA)is an inflammatory disease with autoimmune,environmental,and inherited components directed at the hair follicle,either limited to patchy hair loss over the scalp(Focalis,AF),total loss of scalp hair(Totalis,AT),or total loss of both scalp and body hair(Universalis,AU).Despite multiple treatment modalities,no therapy exists.Vitamin D deficiency in patients with AA/AT/AF influences disease severity and duration,inversely correlating with inflammation histologically.CASE SUMMARY Three girls presented with AT(P1),AU(P2),and AF(P3)at the ages of 1,5,and 5 years,respectively.For P1-P2,all available treatments implemented for 2 years had failed.We started an initial 6-mo repletion with oral cholecalciferol 2000/4000 IU/d,with no apparent effect.Then we attempted immunomodulation using oral calcitriol and its analog paricalcitol.On calcitriol,0.5 mcg/d P1 regrew hair within 6 mo.After 4 years,a relapse with loss of eyebrow hair was resolved after doubling the calcitriol dose to 0.5 mcg×2/d;the results have been maintained for 6 years to date.On calcitriol,0.25 mcg×3/d P2 led to the development of asymptomatic hypercalcemia-hypercalciuria,which was immediately resolved by switching to paricalcitol 2 mcg×3/d;mild tolerable hypercalciuria was maintained.Hair regrowth was observed at 6 mo,stabilizing only as fur at 12 mo.AF in P3 was resolved completely within 3 mo on a daily high dose(8000 IU)of cholecalciferol.CONCLUSION Vitamin D may have immunomodulating therapeutic impact on AT/AU/AF,which needs to be explored with further pilot clinical trials.

关 键 词：Alopecia totalis Alopecia universalis Alopecia focalis CALCITRIOL PARICALCITOL Vitamin D Case report 

分 类 号：R758.71[医药卫生—皮肤病学与性病学]