Significant improvement of facial actinic keratoses after blue light photodynamic therapy with oral vitamin D pretreatment

Abstract

To the Editor: We read with interest the article entitled “Significant improvement of facial actinic keratoses after blue light photodynamic therapy with oral vitamin D pretreatment: An interventional cohort-controlled trial” published by Bullock et al.1Bullock TA, Negrey J, Hu B, Warren CB, Hasan T, Maytin EV. Significant improvement of facial actinic keratoses after blue light photodynamic therapy with oral vitamin D pretreatment: an interventional cohort-controlled trial. J Am Acad Dermatol. Published online March 18, 2022. https://doi.org/10.1016/j.jaad.2022.02.067Google Scholar In the study, a group of patients with actinic keratoses (AK) were pretreated with oral vitamin D3 (10,000 IU daily, 5 or 14 days) prior to aminolevulinic acid photodynamic therapy (PDT) versus another group that only received the aminolevulinic acid PDT treatment.1Bullock TA, Negrey J, Hu B, Warren CB, Hasan T, Maytin EV. Significant improvement of facial actinic keratoses after blue light photodynamic therapy with oral vitamin D pretreatment: an interventional cohort-controlled trial. J Am Acad Dermatol. Published online March 18, 2022. https://doi.org/10.1016/j.jaad.2022.02.067Google Scholar The authors found that the clearance rate of facial AK was lower in patients with vitamin D deficiency (25(OH)D3, <31 ng/dL) compared with those with 25(OH)D3 levels above this limit. In this sense, we would like to make note that our group previously published a study in which the influence of serum 25(OH)D3 on the effectiveness of PDT for AK was demonstrated.2Moreno R. Nájera L. Mascaraque M. Juarranz Á. González S. Gilaberte Y. Influence of serum vitamin D level in the response of actinic keratosis to photodynamic therapy with methylaminolevulinate.J Clin Med. 2020; 9: 398Crossref Scopus (8) Google Scholar In this study, we evaluated the association between vitamin D status and the response of actinic keratoses to photodynamic therapy with methylaminolevulinate and red light in 25 patients. Basal serum levels of 25(OH)D3 were higher in those patients with a positive histologic response to the treatment (26.96 [SD 7.49] ng/mL) than those without response (18.60 [SE 7.49] ng/mL) (P = .05). The vitamin D receptor immunohistochemical expression was also evaluated in histologic samples showing that those with a complete clinical response displayed lower basal vitamin D receptor expression (35.71% [SD 19.8]) than partial responders (62.78% [SD 16.7]) (P = .002). Our results were in agreement with those found now in Bullock’s study, supporting the beneficial effect of an optimal vitamin D status in the response of AK to PDT. None disclosed. Reply to letter to the editorJournal of the American Academy of DermatologyPreviewTo the Editor: We would like to thank the editor for the opportunity to respond to the commentary by Gilaberte et al1 regarding our recently published article, “Significant improvement of facial actinic keratoses after blue light photodynamic therapy with oral vitamin D pretreatment: An interventional cohort-controlled trial.”2 Full-Text PDF