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Case Reports
. 2017 Oct 1;153(10):1018-1020.
doi: 10.1001/jamadermatol.2017.2446.

Treatment of Hailey-Hailey Disease With Low-Dose Naltrexone

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Free PMC article
Case Reports

Treatment of Hailey-Hailey Disease With Low-Dose Naltrexone

Lauren N Albers et al. JAMA Dermatol. .
Free PMC article

Erratum in

  • Error in Affiliation.
    JAMA Dermatol. 2017 Oct 1;153(10):1072. doi: 10.1001/jamadermatol.2017.3904. JAMA Dermatol. 2017. PMID: 28877290 Free PMC article. No abstract available.

Abstract

Importance: Hailey-Hailey disease is a severe genetic blistering disease of intertriginous skin locations that can lead to poor quality of life and increased morbidities. Multiple therapies are available with inconsistent outcomes and potentially severe adverse effects.

Objective: To determine whether low-dose naltrexone is an effective treatment for Hailey-Hailey disease.

Design, setting, and participants: This study was a case series performed at a dermatology outpatient clinic of 3 patients with severe Hailey-Hailey disease recalcitrant to at least 4 therapies.

Interventions: Low-dose naltrexone, 3 mg nightly, titrated to 4.5 mg nightly in 2 patients.

Main outcomes and measures: Reduction in size of lesions as well as subjective improvement of symptoms.

Results: All 3 patients noted significant healing of erosions and plaques starting from the peripheral aspect within 1 to 2 weeks of treatment, and clinical resolution of lesions within 2 months. Discontinuation of low-dose naltrexone resulted in flaring of symptoms, which cleared within 2 to 3 days on rechallenge with low-dose naltrexone.

Conclusions and relevance: We present herein 3 cases of patients with severe Hailey-Hailey disease treated with low-dose naltrexone who achieved clinical resolution of symptoms. The success of these cases suggests low-dose naltrexone as a novel therapy for Hailey-Hailey disease. The possible mechanism may involve low-dose naltrexone influencing opioid or toll-like receptor signaling to improve calcium mobilization and improve keratinocyte differentiation and wound healing. Future studies are needed to clarify the mechanism and to define the role of low-dose naltrexone for treatment of Hailey-Hailey disease.

Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure.
Figure.. Clinical Images of Resolution of Hailey-Hailey Lesions Following Treatment With Low-Dose Naltrexone, Patient 2.
A, Left side of the groin at baseline. B, Complete resolution of lesions 4 months after initiating treatment with low-dose naltrexone.

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