Variable response to low-dose naltrexone in patients with Darier disease: a case series.


Journal

Journal of the European Academy of Dermatology and Venereology : JEADV
ISSN: 1468-3083
Titre abrégé: J Eur Acad Dermatol Venereol
Pays: England
ID NLM: 9216037

Informations de publication

Date de publication:
May 2019
Historique:
received: 16 10 2018
accepted: 19 12 2018
pubmed: 4 2 2019
medline: 18 12 2019
entrez: 4 2 2019
Statut: ppublish

Résumé

Darier disease is a rare autosomal-dominant genodermatosis with a loss of function of a Ca To assess the efficacy of low-dose naltrexone as a treatment option in Darier disease. Six patients with biopsy-proven Darier disease (four had severe, one had moderate and one mild clinical manifestations). The patients received off-label therapy with naltrexone [5 mg per os (p.o.)] and magnesium [200 mg p.o.]. Patients were followed up every 4 weeks for minimally 12 weeks. Upon clinical presentation, the disease severity and subjective pain and itch scores were assessed, and standardized photographs were obtained. The clinical response to naltrexone varied after 12 weeks. The four patients with severe Darier disease showed worsening after initial improvement during the first 4 weeks, whereas the two patients with a mild to moderate clinical manifestation clearly improved, showing almost full remission after 12 weeks with complete flattening of the keratotic papules. Low-dose naltrexone did not have an effect on severe Darier disease compared to Hailey-Hailey disease, but it was beneficial in mild to moderate forms of the disease. Further studies are needed to confirm these observations of variable responses.

Sections du résumé

BACKGROUND BACKGROUND
Darier disease is a rare autosomal-dominant genodermatosis with a loss of function of a Ca
OBJECTIVE OBJECTIVE
To assess the efficacy of low-dose naltrexone as a treatment option in Darier disease.
METHODS METHODS
Six patients with biopsy-proven Darier disease (four had severe, one had moderate and one mild clinical manifestations). The patients received off-label therapy with naltrexone [5 mg per os (p.o.)] and magnesium [200 mg p.o.]. Patients were followed up every 4 weeks for minimally 12 weeks. Upon clinical presentation, the disease severity and subjective pain and itch scores were assessed, and standardized photographs were obtained.
RESULTS RESULTS
The clinical response to naltrexone varied after 12 weeks. The four patients with severe Darier disease showed worsening after initial improvement during the first 4 weeks, whereas the two patients with a mild to moderate clinical manifestation clearly improved, showing almost full remission after 12 weeks with complete flattening of the keratotic papules.
CONCLUSION CONCLUSIONS
Low-dose naltrexone did not have an effect on severe Darier disease compared to Hailey-Hailey disease, but it was beneficial in mild to moderate forms of the disease. Further studies are needed to confirm these observations of variable responses.

Identifiants

pubmed: 30712317
doi: 10.1111/jdv.15457
doi:

Substances chimiques

Dermatologic Agents 0
Naltrexone 5S6W795CQM
Sarcoplasmic Reticulum Calcium-Transporting ATPases EC 3.6.3.8
ATP2A2 protein, human EC 7.2.2.10
Isotretinoin EH28UP18IF
Acitretin LCH760E9T7

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

950-953

Informations de copyright

© 2019 European Academy of Dermatology and Venereology.

Auteurs

D Boehmer (D)

Dermatology, Technical University of Munich, Munich, Germany.

K Eyerich (K)

Dermatology, Technical University of Munich, Munich, Germany.

U Darsow (U)

Dermatology, Technical University of Munich, Munich, Germany.

T Biedermann (T)

Dermatology, Technical University of Munich, Munich, Germany.

A Zink (A)

Dermatology, Technical University of Munich, Munich, Germany.

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Classifications MeSH