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Prurigo excoriée treated with low dose naltrexone
Leonard Timoney1, Christopher B Bunker2
1Department of Dermatology, University College London Hospitals NHS Foundation Trust, London, UK.
BMJ Case Reports
|November 20, 2021
Summary
Low dose naltrexone (LDN) offers significant relief for chronic pruritus excoriée, a condition often resistant to conventional treatments. This case study highlights LDN
Area of Science:
- Dermatology
- Neurology
- Psychiatry
Background:
- Chronic pruritus excoriée is a debilitating condition characterized by an intense itch-scratch cycle.
- This patient presented with a 25-year history of acne excoriée and prurigo excoriée, significantly impacting her quality of life and sleep.
- Previous treatments, including topical agents, phototherapy, isotretinoin, antibiotics, anxiolytics, and neuromodulators, were ineffective.
Observation:
- The patient experienced severe pruritus and scarring due to persistent scratching.
- Her symptoms began following a significant life event, suggesting a potential psychogenic component.
- The itch-scratch cycle was refractory to a multi-modal treatment approach.
Findings:
- Initiation of low dose naltrexone (LDN) at 3 mg nocte resulted in complete resolution of pruritus within weeks.
- The patient reported a significant improvement in her quality of life after commencing LDN therapy.
Implications:
- Low dose naltrexone (LDN) may represent a novel and effective therapeutic option for refractory pruritus excoriée.
- Further research into the neurobiological mechanisms underlying LDN's efficacy in treating psychogenic itch is warranted.
- This case underscores the importance of considering novel therapeutic strategies for chronic, treatment-resistant dermatological conditions.
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