1. Calciferol treatment produced clinical and histological
healing in fifteen out of forty cases of tuberculosis
cutis (lupus vulgaris).
2. Effective therapeutic action was found on the tubercle
systems of Lupus Vulgaris.
3. The findings tend to indicate that this action is nonspecific.
4. Histopathological assay of the disease at intervals
during treatment revealed the structural changes involved
in the chemotherapeutic effect of the drug.
5. Histologically the action of calciferol on tuberculosis
cutis is found to be resolution of the tubercle systems,
starting with the epithelioid cells and followed by the
lymphocytic and mononuclear cell exudates, leaving a
variable residuum of fibrous connective tissue.
6. The findings support the view that the mode of action
of calciferol is by promoting the cellular metabolic
disposal of irritant substances arising from tubercle
bacilli; that it occurs in the cytoplasm of the phagocytic
cells; and that this is adequate only in dealing
with small quantities of such substances.
7. No special or characteristic type of fibrosis follows
calciferol therapy but there is no apparent resolution
of fibrous or scar tissue already created by the disease
process.
8. The disease is capable of reactivation from persistent
microscopic foci remaining after apparent clinical
healing if treatment is insufficiently prolonged. It is
necessary to continue treatment or to give a repeat
course of the drug to ensure against such relapses.
9. Doses of 150,000 i.u. daily of calciferol are well
tolerated by the average case and can be safely com-
bined with ultraviolet light irradiation without causing
toxic effects.
10. Local application of calciferol to the diseased area in
a concentration of 5000 i.u. per gm. of cold cream base
is found to accelerate clinical healing in lupus vulgaris.
11. In Lupus Vulgaris the period of administration is
primarily governed by the clinical state of the patient.
In the absence of any toxic manifestations the average
case may continue treatment for 6 -12 months by which
time any significant benefit should have resulted.
12. Confirmation of healing is made by histopathological
examination of biopsy material from the lesions.
13. All treated cases should be reviewed at intervals of
three to six months for at least several years, if not
for life
