{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:02:46Z","timestamp":1789574566231,"version":"build-2803163510"},"reference-count":24,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"\n Importance<\/jats:title>\n Severe cutaneous toxic effects from chemotherapy and radiation often require treatment interruptions. High-dose oral vitamin D (hdVD) has shown potential as a rapid immunomodulator in experimental models and small human studies, but robust clinical data in oncology populations remain limited.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the clinical response, safety profile, and time to improvement for hdVD in patients with toxic erythema of chemotherapy (TEC) and acute radiation dermatitis (ARD).<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective multicenter case series included 33 patients treated across 3 academic medical centers between December 2021 and January 2024. Eligible participants were those receiving hdVD (100\u202f000 international units) for TEC or ARD with at least 10 days of follow-up.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n One or 2 oral doses of 100\u202f000 international units of cholecalciferol or ergocalciferol.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcomes were time to patient-reported symptomatic relief and clinician-assessed objective improvement in erythema (using a 5-point Likert scale). Secondary outcomes included changes in serum calcium and the ability to continue anticancer therapy.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 33 patients (mean [SD] age, 60.9 [14.6] years; 19 [58%] female), 28 (85%) had TEC and 5 (15%) had ARD. Subjective symptom relief was reported by 26 of 30 patients (87%) within 10 days of treatment. The median (range) time to improvement was 5 (1-28) days overall and 3 (1-16) days for the inpatient subgroup. The mean (SD) Likert erythema score decreased from 4.36 (0.60) at baseline to 2.21 (1.36) by day 10. Patients with neutrophilic eccrine hidradenitis and Stevens-Johnson syndrome\/toxic epidermal necrolysis\u2013like subtypes showed the most rapid responses. No meaningful changes in serum calcium levels were observed, and 24 of the 33 patients (73%) continued anticancer therapy without interruption. No treatment-related adverse events were reported during the study.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this case series, hdVD was associated with rapid symptomatic and objective improvement in chemotherapy- and radiation-induced toxic effects of the skin without treatment-related adverse events. These findings support further study of hdVD as a supportive care approach in oncodermatology.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamadermatol.2026.2267","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T15:00:21Z","timestamp":1784127621000},"page":"888","source":"Crossref","is-referenced-by-count":2,"title":["High-Dose Oral Vitamin D for Toxic Effects of the Skin Associated With Chemotherapy and Radiation"],"prefix":"10.1001","volume":"162","author":[{"given":"Mihir K.","family":"Patil","sequence":"first","affiliation":[{"name":"Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana"},{"name":"Department of Dermatology and Center for Cutaneous Oncology, Brigham and Women\u2019s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goranit","family":"Sakunchotpanit","sequence":"additional","affiliation":[{"name":"Tufts University School of Medicine, Boston, Massachusetts"},{"name":"Department of Dermatology and Center for Cutaneous Oncology, Brigham and Women\u2019s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushila A.","family":"Toulmin","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts"},{"name":"Harvard Combined Dermatology Residency Training Program, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Braun","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Milosavljevic","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farrah L.","family":"Ezzeddine","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas Z.","family":"Rohan","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Austin","family":"Wyant","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren M.","family":"Guggina","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Dermatology and Center for Cutaneous Oncology, Brigham and Women\u2019s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinod E.","family":"Nambudiri","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Dermatology and Center for Cutaneous Oncology, Brigham and Women\u2019s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Iriarte","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"2","key":"doi260026r1","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.163789","article-title":"Vitamin D3 and deconvoluting a rash.","volume":"8","author":"Ernst","year":"2023","journal-title":"JCI Insight"},{"issue":"10","key":"doi260026r2","doi-asserted-by":"publisher","first-page":"2078","DOI":"10.1016\/j.jid.2017.04.040","article-title":"Oral vitamin D rapidly attenuates inflammation from sunburn: an interventional study.","volume":"137","author":"Scott","year":"2017","journal-title":"J Invest Dermatol"},{"issue":"2","key":"doi260026r3","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1001\/jamadermatol.2022.5397","article-title":"High-dose vitamin d for the management of toxic erythema of chemotherapy in hospitalized patients.","volume":"159","author":"Nguyen","year":"2023","journal-title":"JAMA Dermatol"},{"key":"doi260026r4","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.jdcr.2023.07.001","article-title":"High-dose vitamin D for the management acute radiation dermatitis.","volume":"39","author":"Nguyen","year":"2023","journal-title":"JAAD Case Rep"},{"issue":"7","key":"doi260026r5","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1056\/NEJMoa055218","article-title":"Calcium plus vitamin D supplementation and the risk of fractures.","volume":"354","author":"Jackson","year":"2006","journal-title":"N Engl J Med"},{"issue":"1-2","key":"doi260026r6","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/j.mce.2011.05.017","article-title":"Vitamin D metabolism and function in the skin.","volume":"347","author":"Bikle","year":"2011","journal-title":"Mol Cell Endocrinol"},{"issue":"1","key":"doi260026r7","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s11154-011-9194-0","article-title":"Vitamin D and the skin: physiology and pathophysiology.","volume":"13","author":"Bikle","year":"2012","journal-title":"Rev Endocr Metab Disord"},{"issue":"5","key":"doi260026r8","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1080\/15548627.2019.1569298","article-title":"Vitamin D improves sunburns by increasing autophagy in M2 macrophages.","volume":"15","author":"Das","year":"2019","journal-title":"Autophagy"},{"issue":"3","key":"doi260026r9","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1016\/j.jaad.2024.05.027","article-title":"High-dose oral vitamin D: an emerging therapeutic for skin toxicities associated with cancer treatment.","volume":"91","author":"Choi","year":"2024","journal-title":"J Am Acad Dermatol"},{"key":"doi260026r10","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2023.211","article-title":"Vitamin D3 and its potential to ameliorate chemical and radiation-induced skin injury during cancer therapy.","volume":"18","author":"Nguyen","year":"2024","journal-title":"Disaster Med Public Health Prep"},{"issue":"5","key":"doi260026r11","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1038\/bmt.2012.218","article-title":"Toxic erythema of chemotherapy following i.v. 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