High-Dose Vitamin D for the Management of Toxic Erythema of Chemotherapy in Hospitalized Patients

Abstract

Toxic erythema of chemotherapy (TEC) is a unifying term for the broad spectrum of cutaneous dose-dependent cytotoxic reactions that may occur with receipt of chemo- therapeutic agents. In acute cases of TEC, patients can develop severe erythema, pain, swelling, and/or blistering, which may require inpatient management. However, therapeutic options for TEC are limited. Chemotherapy ces- sation, delay, or dose modification are the only reliable methods of resolving TEC. Supportive agents, such as high- potency topical corticosteroids, topical keratolytics, wound care, and pain control, have a variable response. These agents are associated with relatively slow improvement, involving 2 to 4 weeks of recovery after chemotherapy interuption.

TAKE-HOME MESSAGE

• This case series describes the clinical outcomes in 6 hospitalized patients with toxic erythema of chemotherapy (TEC) treated with high-dose vitamin D. In total, 5 patients had a hematologic condition, and 1 patient had glioblastoma multiforme. The patients received 50,000 to 100,000 IU of vitamin D once with repeat administration 1 week later, and improvement in symptoms was reported within 1 to 4 days.
• High-dose vitamin D should be considered as a relatively safe treatment option for patients with TEC, a condition with currently limited therapeutic options.

–  Ruth McTighe, MD

JAMA Dermatology

High-Dose Vitamin D for the Management of Toxic Erythema of Chemotherapy in Hospitalized Patients

JAMA Dermatol 2022 Dec 21;[EPub Ahead of Print], CV Nguyen, L Zheng, XA Zhou, MK Ernst, Y Kye, JN Choi, KQ Lu 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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