[Pain of the musculoskeletal system of unknown origin in immigrants. Vitamin D3 deficiency caused by insufficient exposure of the skin to sunlight].

We present two patients with vitamin D3 deficiency caused by insufficient exposure of the skin to sunlight. The deficiency was due to the dark pigmentation of the skin in the first case and caused by constant wearing of veil and all-covering clothes as well as by insufficient exposure to sunlight in the second case. Both patients developed osteomalacia with musculoskeletal problems; they had typical laboratory test results (elevated alkaline phosphatase and serum calcium in the low normal range) and radiologically evident, non-dislocated fractures (insufficiency fractures). Treatment with vitamin D3 led in both cases to sustained relief of pain.