Vitamin D and skin repair: a prospective, double-blind and placebo controlled study in the healing of leg ulcers.
Rev Col Bras Cir. 2012 Oct;39(5):401-407.
[Article in English, Portuguese]
Burkiewicz CJ, Guadagnin FA, Skare TL, Nascimento MM, Servin SC, Souza GD.
Faculdade Evangélica do Paraná, Hospital Universitário Evangélico de Curitiba, Curitiba, PR, Brasil.
To analyze the relation between vitamin D insufficiency and wound healing in patients with venous ulcers; to correlate vitamin D insufficiency with characteristics of the ulcer (size and pain) and to evaluate if reposition of vitamin D in these subjects expedites ulcer healing.
We selected 26 patients with leg ulcers, and 26 control patients without ulcers, matched for gender, age, systemic arterial hypertension and tobacco use. The venous ulcer group was divided in two subgroups: one that received placebo (nine patients) and other receiving vitamin D, 50.000 IU per week over two months (13 patients). Blood was collected for 25 OH vitamin D dosage before and after the medication. In the ulcer group, we obtained data concerning demographics, leg ulcer size, as well as pain severity, measured by an analogical visual scale. Data was grouped in contingency and frequency tables, the tests of Fisher and chi-squared being used for nominal variables and Mann-Whitney for numerical variables. The adopted significance was of 5%.
We found vitamin D insufficiency in the great majority of the patients.
The median level in the ulcer group was 17.05 ng/dl and 22.75 ng/dl in the group without ulcer (p=0,0182)
No relation was found between the ulcer size without treatment and the level of vitamin D.
After treatment, the average size of the ulcer changed from
- 25 cm² to 18 cm² in the patients that took vitamin D and from
- 27 cm² to 24,5 cm² in the placebo group (p=0,7051 and p=0,7877, respectively).
Considering the variability of the size of the ulcer in the treatment group versus placebo group, the average size was equal to -0,75 cm² in the first group and +4cm² in the second (p=0,0676)
Patients with leg ulcers have more vitamin D deficiency.
No difference in the ulcer characteristics was noted between those with and without vitamin D deficiency.
There was a trend toward a better healing in those with vitamin D reposition.
– – – – – – – – – – – - - - - - - - - - - - -
Vitamin D: 1 - 18/25 =38%
Placebo: 1 - 24.5/27 = 9%
Ulcers of Vitamin D group decreased 4X faster than placebo group
Suspect that had the vitamin D deficiency been previously treated that there would have been fewer leg ulcers.
Suspect that many of the leg ulcers were those of diabetics - who typically have a low level of vitamin D
A previous paper on same study by the same authors had the following graphic and caption
Distribution in percentages of serum 25 OH-vitamin D in control subjects (n=58) and with venous ulcers (n=27) with p=0.04.
It can be seen that 46.1% of patients with ulcers have values of 25 OH-vitamin D between 8 and 20 ng/dl and 43% of control patients have values above 30 ng/dl (p=0.04).
The authors speculate that this can be due to the fact that patients with venous ulcers were told to stay at home as part of treatment.
They also use more clothes in order to avoid the unpleasant odor and bad aesthetic appearance of the wounds, factors that can promote deficiency by decreasing the synthesis of epidermal action of ultra violet rays.
PDF (in English) is attached at the bottom of this page
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