Vitamin D and skin repair: a prospective, double-blind and placebo controlled study in the healing of leg ulcers Vitamina D e cicatrização de pele: estudo prospectivo, duplo-cego, placebo controlado na cicatrização de úlceras de perna

Objective: 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 speeds up the healing of the ulcer. Methods: Were selected 26 patients with leg ulcers, and 26 patients without 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 that received 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, demographic data, leg ulcer size as well as pain severity measured by analogical visual scale were obtained. Data was grouped in contingency and frequency tables and the test of Fisher and chi-squared were used for nominal variables and Mann-Whitney for numerical variables. The adopted significance was of 5%. Results: Was 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) Was not found any relation between the ulcer size without treatment and the level of vitamin D. After treatment in the patients that took vitamin D the median size of the ulcer changed from 25 cm to 18 cm and in the placebo group changed from 27 cm to 24,5 cm (respectively p=0,7051 and p=0,7877). Considering the variability of the size of the ulcer in the treatment group versus placebo group, the median size was equal to -0,75 cm in the first group and +4cm in the second (p=0,0676) Conclusion: 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.