Vulvar Hailey–Hailey disease treated with low-dose naltrexone: case report and literature review

To report a case of vulvar familial benign pemphigus, or Hailey–Hailey disease, treated successfully with low-dose naltrexone and to review the current literature. We report a case of a 71-year-old white woman with vulvar Hailey–Hailey disease recalcitrant to topical corticosteroids. After treatment with low-dose naltrexone, 3 mg nightly was initiated, the lesions began to heal and 5 months later her skin showed no lesions. A literature review on the use of low-dose naltrexone for Hailey–Hailey disease was performed. We searched the PubMed/MEDLINE databases for previous case reports using the key words ‘‘Pemphigus, Benign Familial’’ and ‘‘naltrexone”. We found 35 more cases of Hailey–Hailey disease treated with naltrexone, showing promising results, reported until January 2020, with no major adverse effects. Low-dose naltrexone may represent a cost-effective and successful treatment modality in nongeneralized Hailey–Hailey disease without serious adverse effects. Future prospective studies are needed to investigate this interesting therapeutic option.