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Curr Drug Targets. 2019 Mar 18. doi: 10.2174/1389450120666190318121122. [Epub ahead of print]

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

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1
Department of Dermatology, Medical University of Warsaw, Warsaw. Poland.

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.

KEYWORDS:

Toll-like receptor.; alopecia; low dose naltrexone; opioid growth factor; pruritus; psoriasis

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