For patients with actinic keratoses (AK), high-dose oral vitamin D3 (VD3) significantly improves response to photodynamic therapy (PDT), according to a study published online March 18 in the Journal of the American Academy of Dermatology .

Noting that VD3 combined with PDT can improve clearance of AK in mouse skin cancer models, Taylor A. Bullock, M.D., from the Lerner Research Institute in Cleveland, and colleagues examined whether oral VD3 can improve clinical efficacy of a PDT regimen in humans with AK. Twenty-nine patients received gentle debridement and 15 minutes of 5-aminolevulinic acid preincubation, followed by blue light (30 minutes; 20 J/cm ² ; group 1) and 29 patients took oral VD3 daily (10,000 IU daily for five or 14 days) prior to debridement/PDT (group 2).

The researchers found that the mean clearance rates of facial AK were lower in group 1 for patients with VD3 deficiency (25 hydroxyvitamin D3 [25OH-D3], <31 ng/dL) compared with those with normal 25OH-D3 levels (clearance rate, 40.9 ± 42 percent versus 62.6 ± 14.2 percent). Compared with group 1, overall AK lesion response was significantly improved with high-dose VD3 supplementation (group 2; 72.5 ± 13.6 versus 54.4 ± 22.8 percent). Side effects did not differ between the groups.

"Despite remaining biological unknowns, the practical value of this new VD3/PDT regimen is that practitioners can use it immediately to benefit patients with widespread facial AK," the authors write.

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