ESPE Abstracts (2018) 89 P-P2-290

Successful Treatment of Severe Atopic Dermatitis with Calcitriol and Paricalcitol in an 8-Year Old Girl

Christina Bothoua, Alexis Alexopoulosb, Eleni Dermitzakic, Kleanthis Kleanthousd, Anastasios Papadimitrioud, George Mastorakose & Dimitrios T Papadimitriouc

aGoethe University Clinic, Frankfurt am Main, Germany; b1st Department of Pediatrics, University of Athens, Aghia Sofia Children’s Hospital, Athens, Greece; cDepartment of Pediatric – Adolescent Endocrinology and Diabetes, Athens Medical Center, Athens, Greece; dDivision of Pediatric Endocrinology, 3rd Department of Pediatrics, Attikon University Hospital, Athens, Greece; eEndocrine Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, University of Athens, Athens, Greece

Atopic dermatitis (AD) is a chronic inflammatory disease affecting children and adolescence. The traditional therapeutic options for AD, including emollients topically and immune modulatory agents systemically focusing on reducing skin inflammation and restoring the function of the epidermal barrier, are proven ineffective in many cases. Several studies have linked vitamin D supplementation with either a decreased risk to develop AD or a clinical improvement of the symptoms of AD patients. In this report we present a girl with severe AD who - under adequate supplementation with cholecalciferol, was treated with calcitriol and subsequently with paricalcitol. She had significant improvement – almost healing of her skin lesions within 2 months, a result sustained for 3 years now. Because of hypercalciuria as a side effect from calcitriol therapy, therapy was continued with paricalcitol, a Vitamin D analogue used in secondary hyperparathyroidism in chronic kidney disease. Calcitriol therapy may be considered as a safe and efficacious treatment option for patients with severe AD, particularly for those with refractory AD, under monitoring for possible side effects. Treatment with paricalcitol resolves hypercalciuria, is safe and should be further investigated as an alternative treatment of atopic dermatitis and possibly other diseases of autoimmune origin.

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