Successful treatment of Bowen's disease with topical maxacalcitol

Successful treatment of porocarcinoma with maxacalcitol and imiquimod

This is the first report of a case of porocarcinoma that was successfully treated with maxacalcitol and imiquimod.

Stereoselective reduction of C-20 ketone of vitamin D CD-ring and a new synthetic approach to maxacalcitol

Stereoselective reduction of C-20 ketone of vitamin D CD-ring precursor using Corey's CBS reagents, (R)-(+)-2-methyl-CBS-oxazaborolidine and (S)-(-)-2-methyl-CBS-oxazaborolidine, led to the (20S)-alcohol 5 and (20R)-epimer 4 in approximately 17:1 selectivity. A new synthetic approach to the 22-oxa-25-hydroxy Grundmann's ketone 11 was developed through the Williamson etherification of (20S)-alcohol 5 with 1-bromomethyl-2,2-dimethyloxirane, followed by regioselective reductive epoxide ring opening with LiAlH4, the removal of the silyl protecting group by TBAF, and the environmentally benign TEMPO-mediated oxidation using inexpensive Oxone as a co-oxidizing agent. The preparation of drug maxacalcitol was achieved on gram scale by the convergent Lythgoe coupling via Wittig-Horner reaction of the A-ring phosphine oxide synthon with the CD-ring fragment.

Off-label uses of topical vitamin D in dermatology: a systematic review

BACKGROUND

Topical vitamin D is approved by the US Food and Drug Administration for the treatment of psoriasis but is also used off-label in the treatment of a variety of cutaneous diseases despite a lack of evidence-based guidelines.

OBJECTIVE

The objective of this study was to provide evidence-based clinical guidelines for the off-label use of topical vitamin D in the treatment of dermatologic disease.

METHODS

A systematic literature review was conducted via the MEDLINE, Embase, and CENTRAL databases for off-label uses of topical vitamin D analogues in the treatment of dermatologic disease other than psoriasis. The data were synthesized, and evidence-based recommendations were rendered according to the highest level of evidence available.

RESULTS

A total of 165 articles met the inclusion criteria. A moderate to strong recommendation was given for the use of topical vitamin D in combination with corticosteroids and phototherapy in vitiligo and as monotherapy for various ichthyoses, morphea, pityriasis alba, prurigo nodularis, and polymorphous light eruption. There is evidence showing that topical vitamin D is ineffective in the treatment of actinic keratosis, seborrheic keratosis, lichen planus, seborrheic dermatitis, alopecia areata, chemotherapy-induced alopecia, and hypertrophic scars.

CONCLUSION

Topical vitamin D analogues have an important role in the off-label treatment of dermatologic disease, but higher quality studies are still required.