What Is Vitamin D3 and Its Potential Use in Dermatology?

There are many clinical studies that show the importance of vitamin D in multiple skin disorders. Understanding the molecular elements of cathelicidin expression might lead to new treatments and help explain mechanisms of current therapies. Overall, current data are generating many questions and expectations and require larger trials to confirm the therapeutic use of vitamin D3 supplementation. Vitamin D now represents a vast and promising field of research to dermatologists.

[Trichoepithelioma: a retrospective study 1993-2012 - Dr Manuel Gea González General Hospital]. / Tricoepitelioma: estudio retrospectivo (1993-2012, Hospital General «Dr. Manuel Gea González¼).

BACKGROUND: Trichoepithelioma is a benign follicular tumor, affects young female adults, and has three clinical forms: solitary, multiple, or desmoplastic. Diagnosis represents a clinical challenge for the dermatologist. There are many differential diagnoses, and the most important is basal cell carcinoma because they share histological features. It has good prognosis and therefore treatment is usually for aesthetic purposes, even though it is associated with recurrence. METHODS: This is a retrospective study carried out from January 1993 to December 2012 of all the patients who were diagnosed by histopathology to have trichoepithelioma in the dermatology department of the Dr. Manuel Gea González General Hospital. RESULTS: There were 47 cases, of which 70.2% were female, with an average age of 43.6 years. Solitary trichoepithelioma was the most frequent clinical form (66%) and only three of 14 cases of multiple trichoepithelioma had a positive family history.

[Deep sweet syndrome as a cause or fever of unknown origin. A case report and literature review]. / Síndrome de Sweet subcutáneo como causa de fiebre de origen desconocido. Informe de un caso y revisión de la literatura.

Sweet syndrome is the prototype of neutrophilic dermatosis, which typically presents an intense inflammatory infiltrate of neutrophils in the epidermis and/or dermis, apparently due to a hypersensitivity reaction. This is a case of a 31 year-old woman with fever of more than three weeks duration and erythematous nudosities on her arms and legs. The histological study of a skin lesion showed a lobular inflammatory infiltrate of lymphocytes and neutrophils, with excellent response to prednisone. Therefore, it was concluded as subcutaneous sweet syndrome.

Oral vitamin D3 5000 IU/day as an adjuvant in the treatment of atopic dermatitis: a randomized control trial.

BACKGROUND: Vitamin D has immunomodulatory effects both in the innate and adaptive immune systems, and there is growing scientific evidence demonstrating its relevance in inflammatory processes such as AD. HYPOTHESIS: If vitamin D3 promotes the skin immune system, then it should improve the response to treatment of patients with AD. METHODS: A randomized, double-blind placebo-controlled clinical trial was conducted, which included 65 patients with AD according to Hanifin-Rajka criteria and the severity scale (SCORAD). The patients were divided into two groups to receive either vitamin D3 5000 IU/day (n = 33) or placebo (n = 32), plus baseline therapy (topical steroid, soap substitute, and emollient) during 3 months. RESULTS: Fifty-eight of the 65 enrolled subjects were included in the analysis. At the end of the intervention, the treated group achieved higher levels of 25(OH)D (P < 0.001). At week 12, those patients who registered serum levels of 25(OH)D ≥20 ng/ml, regardless of whether or not they had received supplementation, showed a lower SCORAD compared to those with levels <20 ng/ml (P < 0.001). Eighty percent of the patients with serum levels <20 ng/ml (n = 9) had moderate-severe AD despite standard treatment. Vitamin D levels ≥20 ng/ml associated with baseline therapy strongly favored remission of atopic dermatitis (P = 0.03). No significant differences were found between patients with serum levels of ≥20 ng/ml vs. ≥30 ng/ml. CONCLUSIONS: Reaching serum levels of 25(OH)D > 20 ng/ml in conjunction with standard therapy is sufficient to achieve a reduction in severity (SCORAD) in patients with AD.

[Thrombotic vasculopathy probably associated with cocaine contaminated with levamisole: report of 2 cases]. / Vasculopatía trombótica por cocaína probablemente adulterada con levamisol: reporte de 2 casos.

The vasculities are complex diseases. Their cutaneous manifestations are very important and often mirror several pathologies. Cocaine use has been related to both, vasculitis and thrombotic vasculopathy and pseudovasculitis. A new syndrome has been described in association with its adulteration with levamisole. It can be very serious, leading patients to death. This is relevant as levamisole-adultered cocaine seems to be increasingly offered to consumers. Our goal is to report the first two cases in Mexico, which faces an important raise in cocaine use, emphasizing that a high suspicion based on certain characteristics allows for early recognition and adequate treatment.

Las vasculitis son enfermedades complejas con manifestaciones cutáneas importantes que pueden traducir diversas patologías. El uso de cocaína está relacionado con casos tanto de vasculitis y vasculopatía trombótica, como de pseudovasculitis. Recientemente se ha descrito una condición peculiar asociada a su forma adulterada con levamisol, la cual puede ser incluso mortal, y cuya frecuencia va en aumento. Nuestro objetivo es reportar los primeros dos casos de alta sospecha en México, que enfrenta un incremento en el consumo de cocaína, enfatizando en que ciertas características y la realización de determinados estudios permiten la identificación temprana y el tratamiento adecuado de esta condición.