Author(s) : J. Nakayama, H. Kiryu, K. Urabe, S. Matsuo, S. Shibata, T. Koga, M. Furue, Department of Dermatology, Fukuoka University School of Medicine, 7-45-1, Nanakuma, Jonan-Ku, Fukuoka, 814-0180, Japan..
Summary : Topical application of vitamin D3 analogues for 6 months was found to be effective in improving the pigmentation of café au lait spots in patients with von Recklinghausen’s disease. Treatment of café au lait spots grafted onto nude mice with a vitamin D3 analogue caused suppression of bromodeoxy- uridine uptake in the cells of the basal layer. Vitamin D3 analogues also decreased melanin pigment in café au lait spots after 4 weeks of treatment. Thus, it is considered that long-term application of vitamin D3 analogues is effective both for improving the pigmentation of café au lait spots and suppressing the development of neurofibromas in patients with von Recklinghausen’s disease.
Keywords : 22-oxacalcitriol, tacalcitol, café au lait spot, neurofibroma, vitamin D3, von Recklinghausen’s disease.
Pictures
Figure 1. Epidermis containing parts of a café au lait spot was
grafted onto nude mice, and 22-oxacalcitriol ointment or white vaseline
was topically applied twice a day for 14 days. The grafted skin was resected
for H&E staining. A. Control specimen treated with white vaseline.
B. Specimen treated with 22-oxacalcitriol ointment. There are many
melanophages in the upper dermis showing incontinence of pigment in Figure
1B.
Figure 2. The same skin specimen shown in Figure 1 except that tissue
was immediately frozen for immunostaining with anti-bromodeoxyuridine
antibody. Labeling of the epidermis with bromodeoxyuridine was carried
out as described in Materials and methods. A. Control specimen
treated with white vaseline. B. Specimen treated with 22-oxacalcitriol
ointment.
Figure 3. A large pigmented macule on the back of a patient. Tacalcitol
ointment was topically applied twice a day for 6 months. A. Before
application. B. After treatment for 6 months.
Figure 4. A pigmented macule on the upper arm of a patient was topically
treated with tacalcitol ointment for 4 weeks and was biopsied to study
melanin pigment in the basal layer of the epidermis. A. Before
treatment. B. After 4 weeks of treatment. The upper half of the
macule was treated with tacalcitol ointment
() and the lower half was treated
with white vaseline ().
Figure 5. Fontana-Masson staining of the epidermis of the pigmented macule
shown in Figure 4. A. The upper half of the pigmented macule treated
with tacalcitol ointment. B. The lower half of the pigmented macule
treated with white vaseline.
Printable version
) and the lower half was treated
with white vaseline (
).
