The role of narrowband ultraviolet B phototherapy in the treatment of refractory osteomalacia

Osteomalacia is a disorder of mineralization of newly formed osteoid that can be precipitated through mechanisms that result in hypocalcemia, such as prolonged vitamin D deficiency.Treatment is mainly focused on vitamin D supplementation; however, it can be largely ineffective in malabsorption syndromes.Targeted phototherapy is the localized delivery of ultraviolet light largely used in Dermatology to treat several skin diseases.It is also known that ultraviolet B radiation increases serum 25-hydroxyvitamin D levels.Although its role in the treatment of vitamin D deficiency is largely based on clinical experience, it should be considered, particularly in refractory cases.We report a 60-year-old female with osteomalacia secondary to vitamin D deficiency due to malabsorption after gastric bypass surgery.High dose supplementation of vitamin D and calcium was largely ineffective.Narrowband ultraviolet B was initiated resulting in marked clinical response and normalization of 25-hydroxyvitamin D serum levels.