Case Report Open Access

Successful Treatment of Adult-Onset Dermatitis Herpetiformis with Low Dose Naltrexone

Abstract

Dermatitis herpetiformis can be refractory to a gluten free diet in up to 2% of patients. A celiac disease patient with diet refractory dermatitis herpetiformis was treated with low dose naltrexone. Randomized controlled trials showed that this short acting opioid antagonist is effective therapy in Crohn’s disease and fibromyalgia. The patient’s skin lesions were present for 2 years and went into complete remission within 3 months of taking naltrexone. We theorize that gluten-associated antigens activate long-lasting memory B-lymphocyte cells that produce autoimmune antibodies and this may perpetuate dermatitis herpetiformis. Endorphins produced via up-regulation by low dose naltrexone may reduce this B-cell activity.

Weinstock LB*, Myers TL, Steinhoff M and Smith JP

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