Low-dose Naltrexone: An Alternative Treatment for Erythrodermic Psoriasis

Abstract

This clinical case demonstrates the benefits of patient treatment with low-dose naltrexone (LDN) used in erythrodermic psoriasis. A patient with a confirmed history of psoriasis by histopathology was treated with 4.5 mg of LDN during six months follow-up after an erythrodermic psoriasis flare-up. The patient showed significant improvement in her flare-up and psoriasis remission after only three months of 4.5 mg of LDN on a daily basis. Low-dose naltrexone (LDN) has proven to be a great ally in treating erythrodermic psoriasis flare-ups as an alternative treatment with less collateral side effects.

Keywords: erythomatous psoriasis and ldn; ldn; ldn as a new treatment option for psoriasis; ldn for erythrodermic psoriasis; ldn in dermatology.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1. Initial consultation facial photo

This picture was taken on initial consultation. Dry skin with inflammatory facial edema and superficial scaling was evident, as shown by the arrow. The patient had recently suspended methotrexate treatment.

Figure 2. Bilateral edema of upper and lower extremities (Initial consultation)

Bilateral edema of the upper and lower extremities was evident, associated with itching and redness, as shown by the arrow. The patient mentioned having some difficulty in making a fist with her hand.

Figure 3. Initial consultation photo of the dorsal back

In this photo, we can appreciate the presence of disseminated erythematous plaques throughout the patient's entire body.

Figure 4. After 20 days treatment with 4.5 mg LDN orally.

In this picture, we can observe how low-dose naltrexone (LDN) has shown noticeable improvement in her facial edema. Facial redness had improved by more than 50%, as shown by the arrow. The patient was symptom-free of itching.

Figure 5. After 20 days of treatment with LDN

Significant improvement of bilateral upper extremity edema with an important reduction in the itching sensation obtained with low-dose naltrexone (LDN).

Figure 6. After 20 days of treatment with low-dose naltrexone (posterior dorsal back region)

In this photo, we can easily identify an important reduction after 20 days of low-dose naltrexone (LDN) in disseminated erythematous plaque formation. Only a solitary main plaque was found in the central dorsal posterior region of the back as denoted by the arrow.

Figure 7. Picture after three months of treatment with 4.5 mg LDN orally

In this picture, we can see complete remission of the disease, as pointed to by the arrow after three months of low-dose naltrexone (LDN). Symptom-free (Psoriasis Area Severity Index (PASI) score = 0). The patient was compliant with treatment and did not refer to any side effects of LDN during her treatment. The patient was very pleased with her results.

Figure 8. After three months of treatment with low dose naltrexone

In this photo, we can notice complete remission of the disease after three months of low-dose naltrexone (LDN) treatment. The patient was symptom-free.

Figure 9. After six months of treatment with 4.5 mg LDN orally

After six months of follow-up of low-dose naltrexone (LDN) treatment, the patient showed no signs of psoriasis. Her Psoriasis Area Severity Index (PASI) was 0. Complete remission of the disease was evident. The patient expressed much content with her results and all lab work came back normal.