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The use of naltrexone in dermatology. Current evidence and future directions.

Title
The use of naltrexone in dermatology. Current evidence and future directions.
Publication Type
Journal Article
Research Type
Human
Reported as
Review
Date
March 18, 2019
Authors
Mariusz Sikora, Adriana Rakowska, Małgorzata Olszewska, Lidia Rudnicka
Institution
Medical University of Warsaw
Link
Abstract

Naltrexone is a competitive opioid receptor antagonist approved as supportive treatment in alcohol dependence and opioid addiction. In a dose 50-100 mg daily, naltrexone is used off-label in dermatology for the treatment of trichotillomania and different types of pruritus. At a dose as low as 1-5 mg of drug per day, naltrexone demonstrates immunomodulatory action i.e. modulates Toll-like receptors signaling, decreases release of proinflammatory cytokines (tumor necrosis factor, interleukin-6, interleukin-12), inhibits T lymphocyte proliferation, down-regulates the expression of chemokine receptors and adhesion molecules. The efficacy of standard and low doses of naltrexone in a variety of dermatological disorders has been reported. These include diseases such as familial benign chronic pemphigus (Hailey-Hailey disease), dermatomyositis, systemic sclerosis, psoriasis and lichen planopilaris. Optimistic preliminary findings, low cost of therapy and good tolerance make naltrexone a promising alternative therapy or adjunct drug in dermatology.