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Hailey–Hailey disease successfully controlled with low-dose naltrexone

Hailey–Hailey disease successfully controlled with low-dose naltrexone
Publication Type
Research Type
Reported as
Case Report/Series/Restrospective Study
June 01, 2017
Yumeng Li, Omer Ibrahim, Alok Vij, Stephen Billings, Anthony Fernandez
Cleveland Clinic

Hailey–Hailey disease, or familial benign pemphigus, is a chronic, autosomal dominant or rarely sporadic condition characterized by painful erosions and macerations in the skin folds. Classically, treatment options for this condition include topical steroids, topical and systemic retinoids, and immunomodulators such as methotrexate. Although low-dose naltrexone (LDN) has never been reported in the literature as a treatment for Hailey–Hailey, patients on online blogs, websites, and Facebook support groups have attested to the success of this relatively benign medication in the treatment of their disease. In the scientific literature, LDN has gained attention in the treatment of fibromyalgia, other chronic pain disorders, and even Crohn’s disease. Although the mechanism of action remains unknown, LDN has been shown to reduce proinflammatory molecules, such as tumor necrosis factor and superoxide radicals. Also, LDN is believed to reduce inflammation by acting on toll-like receptor 4. Our patient with Hailey–Hailey disease reports that LDN 1.5 mg daily completely clears her skin. In the rare event of a disease flare, she increases her dosage to 3 mg daily for a few days, which relieves her symptoms. Hailey–Hailey is generally not considered an autoinflammatory disease, and the mechanism of action of LDN in this condition is unknown; however, a role in calcium homeostasis is a possibility.