Role of Vitamin D Supplementation in the Management of Cutaneous Sarcoidosis

Sarcoidosis is a multisystem inflammatory disorder characterized by granuloma formation, affecting organs like the lungs and skin. Granulomas contain macrophages that can produce 1,25-dihydroxy vitamin D (calcitriol) from 25-hydroxy vitamin D (calcifediol) outside the kidneys. This process lacks an effective feedback mechanism, potentially disrupting calcium balance in sarcoidosis patients. While vitamin D supplementation is considered an adjuvant therapy, it can lead to hypercalcemia. Therefore, vitamin D supplementation should not be routinely administered based on vitamin D level changes alone; appropriate laboratory tests are necessary to minimize hypercalcemia risk. Low-dose vitamin D supplementation is permissible for sarcoidosis patients without hypercalcemia, with regular monitoring of vitamin D and calcium levels.