Phototherapy with UVB narrowband, UVA/UVBnb, and UVA1 differentially impacts serum 25-hydroxyvitamin-D3 - 12/07/13

Doi : 10.1016/j.jaad.2013.04.058

Laurence Feldmeyer, MD, PhD ^a,^⁎ , Golnar Shojaati, MD ^a, Katharina-Susanne Spanaus, MD ^b, Alexander Navarini, MD, PhD ^a, Barbara Theler, MD ^a, Davide Donghi, MD ^a, Mirjana Urosevic-Maiwald, MD ^a, Martin Glatz, MD ^a, Laurence Imhof, MD ^a, Marjam J. Barysch, MD ^a, Reinhard Dummer, MD ^a, Malgorzata Roos, MD ^c, Lars E. French, MD ^a, Christian Surber, MD ^d, Günther F.L. Hofbauer, MD ^a
^a Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
^b Institute for Clinical Chemistry, University Zurich, Zurich, Switzerland
^c Division of Biostatistics, Institut für Sozial- und Präventivmedizin (ISPM), University Zurich, Zurich, Switzerland
^d Department of Dermatology, University of Basel, Basel, Switzerland

^∗Correspondence to: Laurence Feldmeyer, MD, PhD, Department of Dermatology, University Hospital Lausanne CHUV, Avenue de Beaumont 29, 1011 Lausanne, Switzerland.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 12 July 2013

Abstract

Background

Ultraviolet (UV) B radiation increases serum 25-hydroxyvitamin-D3 [25(OH)D], but the influence of UVA1 and UVA/narrowband UVB (UVBnb) phototherapy on serum vitamin D is unknown.

Objective

We sought to investigate the influence of UVBnb, UVA1, and UVA/UVBnb phototherapy on serum levels of 25(OH)D and related parameters in patients with an inflammatory skin condition.

Methods

25(OH)D, as well as calcium, parathormone, phosphate, and albumin were measured before therapy, 2 weeks after start, and after completion of the phototherapy. Diagnoses were divided in 4 groups: atopic dermatitis, psoriasis, morphea, and others.

Results

We surveyed 116 dermatologic patients undergoing phototherapy with UVA1 (n = 38), UVA/UVBnb (n = 30), or UVBnb (n = 48) 2 to 3 times a week for 53 to 90 days. UVBnb phototherapy increased serum 25(OH)D from 22.1 to 39.5 ng/mL after the therapy (P < .001). The lower the baseline 25(OH)D level was, the steeper the increase in 25(OH)D was upon application of UVBnb phototherapy. UVA/UVBnb therapy also increased serum 25(OH)D, from 23.9 to 50.3 ng/mL (P = .003). Conversely, in the UVA1 therapy group, 25(OH)D serum levels decreased significantly from 21.9 to 19.0 ng/mL (P < .001).

Limitations

The study design was open trial without randomization. An influence of a precise skin disease cannot be excluded because of the heterogeneous diagnoses. Bias may have arisen from patient preference for treatment at our center, referral, unrecognized differences in underlying skin disease, and other factors.

Conclusion

Phototherapy with UVBnb and UVA/UVBnb increased 25(OH)D serum level significantly. UVA1 therapy alone induced a reduction in serum 25(OH)D concentrations.

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Key words : inflammatory skin disease, open observational study, phototherapy, ultraviolet A, ultraviolet B, vitamin D

Abbreviations used : 25(OH)D, DLQI, UV, UVBnb

Plan

Methods

Design

Patients

Definition of vitamin D sufficiency

Statistical considerations and methods

Agent doses and administration

Clinical evaluation

Laboratory measurements

Study completion

Results

Population parameters before therapy

Influence of phototherapy on 25(OH)D concentrations

Influence of gender on serum vitamin D level

Influence of season on serum vitamin D level

Influence of phototherapy on the other parameters

Quality of life and phototherapy

Discussion

	Investigator initiated research project funded by Spirig Pharmaceuticals, Egerkingen, Switzerland.
	Conflicts of interest: None declared.
	Reprints not available from the authors.