High-dose vitamin D may reduce skin toxic effects of chemotherapy and radiation

Severe cutaneous toxic effects from chemotherapy and radiation pose substantial challenges due to limited treatment options and the need to continue oncologic therapy. However, treatment interruption is often required to manage these severe cutaneous toxic effects. High-dose oral vitamin D has shown potential as a rapid modulator of acute skin inflammation in experimental models and small human studies, but clinical data in oncology populations remain limited.To further investigate this issue, U.S. researchers evaluated the clinical response, safety profile and time to improvement for high-dose oral vitamin D in patients with toxic erythema of chemotherapy and acute radiation dermatitis.The retrospective multicentre case series included 33 patients treated across three academic medical centres between December 2021 and January 2024. Study participants received high-dose vitamin D (one or two oral doses of 100,000 IU cholecalciferol or ergocalciferol) for toxic erythema of chemotherapy or acute radiation dermatitis, with at least 10 days of follow-up.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.Key results:Among 33 patients (mean age, 60.9 years; 58% female), 28 (85%) had toxic erythema of chemotherapy and five (15%) had acute radiation dermatitis.Subjective symptom relief was reported by 26 of 30 patients (87%) within 10 days of treatment. The median time to improvement was five (range 1–28) days overall (inpatients and outpatients combined) and three (range 1–16) days for the inpatient subgroup. The mean Likert erythema score decreased from 4.36 at baseline to 2.21 by day 10. Patients with neutrophilic eccrine hidradenitis and Stevens-Johnson syndrome/toxic epidermal necrolysis–like subtypes showed the most rapid responses. No meaningful changes in serum calcium levels were seen.A total of 24 of the 33 patients (73%) continued anticancer therapy without interruption. No treatment-related adverse events were reported during the study.The authors conclude that in this case series, high-dose oral vitamin D was associated with rapid symptomatic and objective improvement in chemotherapy- and radiation-induced toxic effects of the skin, without treatment-related adverse events. As cancer treatments grow increasingly complex, incorporating high-dose vitamin D into supportive care protocols has the potential to minimize cancer treatment interruptions, mitigate cutaneous toxic effects and improve patient outcomes. The authors believe their findings support further study of high-dose oral vitamin D as a supportive care approach in oncologic dermatology.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; published online July 15, 2026. (accessed July 23, 2026).

High-dose vitamin D may reduce skin toxic effects of chemotherapy and radiation

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