Successful Treatment of Refractory Aquagenic Pruritus with Naltrexone

Ingber, Sarah; Cohen, Paul D.

doi:10.1007/s10227-005-0144-x

Cited by 13 publications

(12 citation statements)

References 10 publications

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“…Both systemic and bath PUVA (also with a reduction of PUVA 1–2‐times a week) [18, 25, 37], the combination of UVA/UVB light [38], as well as narrow‐band and broadband UVB therapy [6, 14, 16, 38] can reduce pruritus symptoms (though only during therapy or) for up to a maximum of 6 months after ending treatment [6]. Other modern drug options include anticonvulsant drugs (e.g., pregabalin) [39], naltrexone [40], and paroxetine [41]. In our experience, pregabalin, in particular, is effective in treating the symptoms of AP [39] and is thus recommended for patients with AP in whom antihistamines have failed.…”

Section: Discussionmentioning

confidence: 99%

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Aquagenic pruritus: associated diseases and clinical pruritus characteristics

Heitkemper

Hofmann

Phan

et al. 2010

J Deutsche Derma Gesell

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AP occurs frequently with polycythemia vera. Other underlying diseases are rare; in over half of the patients no cause can be detected. In 25 % lactose intolerance is present which possibly acts as co-factor. Demographic parameters (age, gender) allow estimation of the possible underlying disease in AP. Pruritus characteristics are similar in all groups and not helpful in determining the origin of AP.

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Section: Discussionmentioning

confidence: 99%

“…Weitere moderne medikamentöse Therapieoptionen stellen Antikonvulsiva (z. B. Pregabalin) [39], Naltrexon [40] und Paroxetin [41] dar. Gemäß unserer Erfahrung hat sich insbesondere die Gabe von Pregabalin bei AP bewährt [39] und sollte daher bei der Therapie des AP nach Versagen von Antihistaminika eingesetzt werden.…”

Section: Discussionunclassified

Aquagenic pruritus: associated diseases and clinical pruritus characteristics

Heitkemper

Hofmann

Phan

et al. 2010

J Deutsche Derma Gesell

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“…Idiopathic AP is conventionally managed with various methods such as the addition of sodium bicarbonate to bath water, antihistamines, topical capsaicin cream, and phototherapy. In addition, mixed results with naltrexone, transdermal nitroglycerin, and beta blockers have been reported . The effect of naltrexone is explained by the possibility of endogenous opiates modifying the peripheral and central sensation of itch.…”

Section: Section Imentioning

confidence: 99%

“…As such, antagonizing the effect of opiates could suppress pruritus. The effect of opiate antagonists has also been reported to be successful with other etiologies of pruritus …”

Section: Section Imentioning

confidence: 99%

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Water‐related dermatoses

Hamie

Abou-Rahal

2018

Int J Dermatology

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Water‐related dermatoses are a spectrum of diseases that are associated with water exposure. They result either from the direct influence of water or after injury from water inhabitants. In this review, clinical entities that manifest after water exposure (aquagenic pruritus, aquagenic urticaria, and aquagenic wrinkling of the palms) will be discussed with particular focus on the reported pathogenesis. Aquatic organisms and activities can be linked to cutaneous injuries that require identification and distinct management. Marine and freshwater dermatoses were summarized to provide physicians with easy access to the causative organism, method of injury, and appropriate management.

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Utility of Naltrexone Treatment for Chronic Inflammatory Dermatologic Conditions

et al. 2019

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IMPORTANCEDermatology is encountering increasing rates of autoimmune disease manifesting in primary skin conditions that are difficult to treat without a risk of immunosuppression. Naltrexone is an orally active opioid antagonist that influences a variety of systemic pathways, including the immune system, in low doses of 1.5 to 4.0 mg/d. This phenomenon has piqued the interest of researchers and practitioners in regard to low-dose naltrexone's potential in the treatment of several autoimmune conditions. OBJECTIVE To review the existing literature on naltrexone treatment for dermatologic conditions.EVIDENCE REVIEW A primary literature search was conducted using PubMed in April 2018 for all articles published from 1971 to April 2018. Search terms consisted of naltrexone or low dose naltrexone or low-dose naltrexone and dermatology or skin or hair or nails. Reviews, animal studies, and nondermatologic and pharmacologic studies were excluded.FINDINGS From 1037 articles, 22 were deemed to be appropriate for inclusion in this review for a qualitative synthesis. The 22 articles included randomized clinical trials, case reports, and series. There were 7 articles on low-dose naltexone, 1 on topical naltrexone, and 14 on high-dose naltrexone use in dermatology. In high, low, and topical doses, naltrexone was effective in treating pruritus attributable to atopic dermatitis, prurigo nodularis, cholestatsis, burn injury, systemic sclerosis, Hailey-Hailey disease, and lichen planopilaris. High-dose naltrexone was ineffective in treating flushing and uremic pruritus most likely because of the lack of opioid involvement in the pathophysiologic mechanisms of these conditions. CONCLUSIONS AND RELEVANCEThe findings suggest that low-dose naltrexone is safe and effective in the treatment of Hailey-Hailey disease and lichen planopilaris and both low-and high-dose naltrexone successfully treat pruritus attributable to various pathologic conditions; however, more adverse effects occurred in those taking high doses. Low-dose naltrexone has the potential for the treatment of chronic inflammatory skin conditions; however, additional evidence is needed for dosing and long-term treatment guidelines.

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Successful Treatment of Refractory Aquagenic Pruritus with Naltrexone

Abstract: Endogenous opiates, like naltrexone, can modify pruritus by influencing the peripheral and central sensation of itch. It has been found to be successful in suppressing the perception of pruritus from many diverse origins including aquagenic pruritus.

Cited by 13 publications

References 10 publications

Aquagenic pruritus: associated diseases and clinical pruritus characteristics

Aquagenic pruritus: associated diseases and clinical pruritus characteristics

Water‐related dermatoses

Utility of Naltrexone Treatment for Chronic Inflammatory Dermatologic Conditions

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