A case series published in JAMA Dermatology reports on the success of three patients with severe Hailey-Hailey disease treated with low-dose naltrexone. 

Current treatments for Hailey-Hailey disease, a severe genetic blistering disease of intertriginous skin, have led to varied clinical outcomes with potentially severe side effects. Study authors from the Emory University School of Medicine, Atlanta, GA, sought to determine if low-dose naltrexone was effective in treating Hailey-Hailey disease. They examined three patients at a dermatology outpatient clinic with severe disease recalcitrant to ≥4 treatments. 

The study patients received naltrexone 3mg each night; two patients were uptitrated to 4.5mg. Researchers evaluated the decrease in lesions and subjective improvement of symptoms.

Within the first two weeks of treatment, all three patients saw significant healing of erosions and plaques, with clinical resolution of lesions within two months. While discontinuation led to flaring of symptoms, these symptoms were cleared within 2–3 days of rechallenge with low-dose naltrexone. 

Low-dose naltrexone is thought to affect the opioid or toll-like receptor signaling to improve calcium mobilization, keratinocyte differentiation, and wound healing.

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“The success of these cases suggests low-dose naltrexone as a novel therapy for Hailey-Hailey disease,” the authors write. 

For more information visit jamanetwork.com.