High-Dose Vitamin D Speeds Recovery in Chemo and Radiation Rash: JAMA
An analysis of a retrospective multicenter study on high-dose oral vitamin D (hdVD) administration in oncological patients suffering from acute skin toxicities found the potential of high-dose oral vitamin D to be highly beneficial for supportive therapy. The findings indicated high-dose oral vitamin D to be associated with significant symptomatic and clinical recovery without any treatment-related side effects. The study was published in JAMA Dermatology by Mihir K. and colleagues.
To study the efficacy and safety of the use of high doses of vitamin D, clinical data from 33 patients undergoing treatment in three academic medical centers within the period of December 2021 to January 2024 were reviewed. Only those patients who received either one or two oral doses of 100,000 IU of cholecalciferol or ergocalciferol for the treatment of TEC or ARD, and had at least 10 days of follow-up were selected.
Time taken by patients to report symptom relief and objective reduction in skin erythema (by using a 5-point Likert scale) were the key parameters studied. The secondary parameters were serum calcium levels and proportion of patients who continued anticancer treatments.
Key findings:
- Longitudinal tracking of the 33 study participants (mean age 60.9 ± 14.6 years; 19 females [58%]), comprising 28 patients (85%) with TEC and 5 (15%) with ARD, yielded distinct quantitative outcomes.
- Patient-reported subjective symptom relief was achieved by 26 of 30 evaluable patients (87%) within 10 days of high-dose vitamin D administration.
- The overall median time to clinical improvement was 5 days (range, 1–28 days), with the inpatient subgroup demonstrating an even faster median recovery of 3 days (range, 1–16 days).
- Objective clinician-assessed Likert erythema scores decreased by over 50%, falling from a baseline mean of 4.36 (SD 0.60) to 2.21 (SD 1.36) by day 10.
- Patients exhibiting neutrophilic eccrine hidradenitis and Stevens-Johnson syndrome/toxic epidermal necrolysis–like TEC subtypes demonstrated the most rapid clinical responses.
- A total of 24 out of 33 patients (73%) successfully continued their primary anticancer therapy without experiencing dose interruptions.
- Serum calcium levels remained stable across all patients with no meaningful changes observed, and zero treatment-related adverse events were reported.
In summary, high-dose oral vitamin D intake has been found to result in quick relief from subjective as well as objective symptoms of acute chemotherapeutic and radiotherapy induced cutaneous toxicity. The findings of this research paper have highlighted the effectiveness, safety and scalability of hdVD. Inclusion of hdVD in the field of oncodermatology may help avoid complications.
Reference:
Patil MK, Sakunchotpanit G, Toulmin SA, et al. High-Dose Oral Vitamin D for Toxic Effects of the Skin Associated With Chemotherapy and Radiation. JAMA Dermatol. 2026;162(9):888–893. doi:10.1001/jamadermatol.2026.2267
