Low-dose naltrexone may be a low-cost and low-risk alternative or additional treatment for familial benign pemphigus, or Hailey-Hailey disease (HHD), according to recent findings published in JAMA Dermatology.

HHD is a rare, autosomal-dominant, debilitating condition characterized by erosions, maceration in flexural areas, and chronic, recurring vesicles.

Omer Ibrahim, MD, of the Cleveland Clinic Foundation, and colleagues examined 3 patients with proven recalcitrant HHD. The participants were a woman in her 40s and 2 men in their 60s. Each patient received a low dose (1.5 to 3.0 mg/day) of naltrexone hydrochloride and follow-up was performed every 2 to 3 months. Throughout the treatment, researchers measured clinical responses, such as improvements in erythema, healing of erosions, and lessening of pain as well as any adverse effects and quality of life as described by the patients.

The investigators found that after treatment with low-dose naltrexone, each of the 3 patients showed at least an 80% improvement in the scope of their disease and 1 patient had a 90% improvement.

In addition to markedly improved clinical responses, all patients reported enhanced quality of life and one noted improvement in depression as well. There were no reported adverse effects.

In addition to HHD, low-dose naltrexone may help treat several other inflammatory conditions such as fibromyalgia, complex regional pain syndrome, and multiple sclerosis, the investigators noted.

“Although off label and not approved by the Food and Drug Administration, low-dose naltrexone may represent a low-cost and low-risk alternative or adjunct in the treatment of HHD,” they concluded.

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Reference

Ibrahim O, Hogan SR, Vij A, Fernandez AP. Low-dose naltrexone treatment of familial benign pemphigus (Hailey-Hailey disease) [published online August 2, 2017]. JAMA Dermatol. doi: 10.1001/jamadermatol.2017. 2445