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Derm Pharm 2020 > 2 - Topical Vitamin D3 > Flashcards

2 - Topical Vitamin D3 Flashcards

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Dermatology Board Prep flashcards
1
Q

ProVitamin D3 (7-dehydrocholesterol) is converted to PreVitamin D3 (9,10-secosterol precolecalciferol) in the epidermis by UVB light

A

True

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2
Q

ProVitamin D3 is 7-dehydrocholesterol

A

True

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3
Q

PreVitamin D3 is 9,10-secosterol precolecalciferol

A

True

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4
Q

Temperature-dependant Isomerisation of PreVitamin D3 (9,10 secosterol precolecalciferol) to Vitamin D3 (cholecalciferol) occurs in the epidermis

A

True

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5
Q

Calcitriol (1,25 dihydroxyvitamin D3) is the active hormone

A

True

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6
Q

Vitamin D3 (cholecalciferol) undergoes hydroxylation to 25-hydroxyvitamin D3 in the liver via CYP-450 dependant enzyme 25-hydroxylase

A

True

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7
Q

25-hydroxyvitamin D3 is further hydroxylated to form the active hormone 1,25-dihydroxyvitamin D3 (calcitriol) in the kidney and other tissues

A

True

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8
Q

Keratinocytes have all the necessary enzymes to convert ProVitamin D3 (7-dehydrocholesterol) to 1,25-dihydroxyvitamin D3 (calcitriol)

A

True

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9
Q

Calcitriol (1,25-dihydroxyvitamin D3) is metabolised to 1,24,25-trihydroxyvitamin D3 by 24-hydroxylase in the kidney and skin

A

True (1,24,25-trihydroxyvitamin D3 has very little biological activity as compared to calcitriol)

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10
Q

Topical application of calcitriol to human skin markedly enhances the activity of 24-hydroxylase to metabolise the active hormone to a less active form of 1,24,25-trihydroxyvitamin D3

A

True

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11
Q

Calcitriol acts mainly via the VDR (vitamin D receptor) to regulate cell growth, differentiation, immune function, calcium and phosphorus metabolism

A

True

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12
Q

The VDR (vitamin D receptor) protein belongs to the thyroid hormone, corticosteroid, and retinoids acid nuclear receptor gene family

A

True

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13
Q

Calcitriol inhibits proliferation of keratinocytes

A

True

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14
Q

Calcitriol modulates epidermal differentiation

A

True

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15
Q

Calcitriol inhibits production of interleukin 2 and interleukin 6 by T cells

A

True

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16
Q

Calcitriol blocks transcription of interferon gamma and granulocyte macrophage colony stimulating factor mRNA

A

True

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17
Q

Calcitriol inhibits cytotoxic T cell and natural killer cell activity

A

True

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18
Q

Vitamin D analogues have a reduced risk of hypercalcaemia but preserve other vitamin D mediated cellular effects

A

True

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19
Q

Calcipotriene (calcipotriol) has greater efficacy than calcitriol and tacalcitol

A

True

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20
Q

Calcipotriol is less likely to induce hypercalcaemia and hypercalciuria than tacalcitol

A

True

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21
Q

Calcipotriol is a synthetic analogue of calcitriol

A

True

22
Q

Calcipotriol binds to the Vitamin D Receptor (VDR) with the same affinity as calcitriol but is less likely to cause hypercalcaemia and hypercalciuria than calcitriol

A

True (owing to calcipotriol’s rapid local metabolism when applied topically)

23
Q

Tacalcitol has less hypercalcaemic activity than calcitriol

A

True (tacalcitol differs structurally from calcitriol and similar to calcipotriol, it has less hypercalcaemic activity than calcitriol)

24
Q

Calcipotriol applied twice daily is more effective than once daily application

A

True

25
Q

Twice daily application of calcipotriol is not associated with increased irritation

A

True

26
Q

Calcipotriol is well tolerated in patients with intertriginous psoriasis even though 50% experience minimal burning or slight lesional/perilesional irritation

A

True

27
Q

Calcipotriol is relatively contraindicated in conditions causing hypercalcaemia

A

True

28
Q

Once daily calcipotriol-betamethasone dipropionate combination therapy showed similar efficacy to twice daily calcipotriol monotherapy in the treatment of nail psoriasis

A

True (due to once daily dosing the calcipotriol-betamethasone dipropionate combination application may improve patient compliance)

29
Q

Calcipotriol-betamethasone dipropionate combination therapy is more effective and has a more rapid effect than calcipotriol or betamethasone dipropionate alone

A

True

30
Q

Topical tacrolimus showed superior efficacy to topical calcitriol for psoriasis on the face or intertriginous areas

A

True

31
Q

Combination of a vitamin D analogue and UV therapy is better than either entity alone

A

True (this combination causes lesions to clear more quickly and produces greater reduction in PASI)

32
Q

Vitamin D analogues have a phototherapy sparing effect in that fewer light treatments and lower levels of radiation are required to induce a clinical response

A

True

33
Q

Application of vitamin D analogues should not be applied immediately prior to phototherapy

A

True (the application of vitamin D analogues prior to UV irradiation induces degradation of the vitamin D analogue and can affect transmission of UV light)

34
Q

Irradiation with UVA can reduce the concentration of calcipotriol

A

True

35
Q

Vitamin D analogues should be applied after phototherapy

A

True

36
Q

Combination of calcipotriol and other immunomodulatory agents I.e. Cyclosporine, acitretin and methotrexate allows lower doses of the systemic agents to be used

A

True (induces clearing of psoriasis at lower doses of the systemic agents)

37
Q

Calcipotriol has been shown to be superior to betamethasone dipropionate in reducing the number and size of prurigo nodules

A

True

38
Q

Patients with morphea treated with calcipotriol under occlusion demonstrated clinically significant improvement with reduction of dyspigmentation, induration, erythema and telengiectasia.

A

True

39
Q

Addition of calcipotriol to psoralen plus ultraviolet A (PUVA) therapy in vitiligo enhanced the effectiveness of PUVA therapy

A

True (combination therapy led to higher percentages of repigmentation than with placebo or PUVA alone + earlier repigmentation and a lower cumulative UVA dose)

40
Q

Calcipotriol and PUVA combination therapy in patients with vitiligo led to higher percentages of repigmentation than with placebo or PUVA alone

A

True

41
Q

Calcipotriol and PUVA combination therapy for vitiligo led to earlier repigmentation and a lower cumulative UVA dose

A

True

42
Q

There is increased efficacy and safety in the calcipotriol-betamethasone dipropionate combination therapy in vitiligo to either treatment given alone

A

True (combination therapy is more superior in efficacy and safety)

43
Q

The recommended cumulative weekly dose for calcipotriol is 100g/week

A

True (calcipotriol can be used with great margin of safety at a dose up to 100g/week)

44
Q

Calcipotriol produces more irritation than calcitriol

A

True

45
Q

Calcipotriol application can cause lesional and perilesional irritation which is self limiting and resolves quickly once the drug is discontinued

A

True

46
Q

Adjunctive topical corticosteroids reduce the likelihood of irritation from topical calcipotriol

A

True

47
Q

Topical calcitriol has not been shown to produce photosensitivity

A

True (contrary to topical calcipotriol, calcitriol has NOT been shown to produce photosensitivity)

48
Q

Burning occurred in patients for whom calcipotriol was added during a course of UVB therapy

A

True

49
Q

Burning did not occur in patients for whom Calcipotriol was started prior to UVB

A

True

50
Q

It is recommended that UVB dosage be reduced slightly when adding a vitamin D analogue to a regimen of UVB

A

True (mild photosensitivity has been reported in psoriatic patients treated with a combination of calcipotriol and UVB therapy)

51
Q

Calcipotriol is a weak contact allergen and contact irritant

A

True

52
Q

Calcitriol has not been shown to produce skin irritation or contact sensitisation

A

True (in contrast to calcipotriol which is a weak contact allergen and irritant)

Derm Pharm 2020 (47 decks)

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