Topical Vitamin D3

shevyatiwari's version from 2015-04-23 02:24


Question Answer
Pro Vit D3 is cleaved by UVAF, UVB
Vit D hydroxylated in liver then kidneys to calcitriolT
1, 24, 25 trihydroxy Vit D is activeF
VDR belongs to thyroid hormone and corticosteroid but not retinoid acid nuclear receptor gene familyF, belongs to all
pre vitamin D3 undergoes temperature independent isomerization to vitamin D3F, temperature dependent
Provitamin D3 undergoes temperature dependent isomerization to previtamin D3F, via UVB
Vit D3 binds to VDR in conjunction with RXR binds to Vitamin D response elementsT
Vitamin D promotes proliferation of keratinocytesF, inhibitss
Vitamin D modulates epidermal differentiationT
Vitamin D promotes the formation of the cornfield envelope by increasing gene expression and levels of involucrin and trnasglutaminaseT
Vit D increases IL2 and IL6F, inhibits
Vit D increases transcription of IFN gamma and GMCSF RNAF, blocks
Inhibits cytotoxic T cell and natural killer cell activityT
Calcitriol is more efficacious than either calcipotriene or tacalcitolF, calcipotriene more efficacious than either
Calcicipotriene is more likely to inducer hypercalcaemia and hypercalciuria than tacalcitolF, less likely
Calcipotriene aka calcitriolF, aka calcipotriol
Calcipotriene is a synthetic analogue of calcitriolT
Calcipotriene binds to VDR with higher affinity than calcitriolF, same affinity
Caclipotriene undergoes rapid local metabolism topicallyT - thus decreases risk of hypercalcemia
Calcitriol is the natural active form of Vit DT
Calcitriol is available IVT, as well as PO
Tacalcitol differs to calcitriol in the position of its hydroxyl groupT
Tacalcitol causes less hypercalcaemia than calcitriolT
Calcipotriene BD is more effective than ODT
Calcipotriene BD is associated with more S/E than ODF
Calcipotriene is comparable to TCS at 8/52T
In children, improves PASI cf vehicleF, but does reduce redness/scaliness
The combination of calcipotriene with betamethasone shows more effect than either agent aloneT
Vit D analogues have a phototherapy sparing effecT
Vit D analgoues should be applied before phototherapyF, after
Safe with Mtx, cyclosporin, acitretin, etanerceptT
Darier's, palmoplantar keratoderma, KP respond to calcipotrieneF
Useful in prurigoT
Has been shown to improve morpheaT
May be useful in vitilgo esp in combination with diprosone and UVAT
Recc dose <100g/weekT
At doses 300-360, hpercalcemia occurs in <50% and resolves in 3/7T
Calcitriol is less irritating than calcipotrieneT
Addition of TCS reduces the risk of irritationT
Weak allergen/contact irritatnT
Category CT

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