A University of Miami Health System study found that low-dose naltrexone treatment yielded clinical improvement in 4 of 7 patients with nail lichen planus, with a 35% reduction in disease severity.

In the retrospective case series, published in JAMA Dermatology, researchers examined the outcomes of patients who received oral low-dose naltrexone (LDN) at 3 mg daily as monotherapy. Treatment periods ranged from 2 to 11 months.

The study included 7 patients (mean age = 60 years, range = 38–77 years). Six of the patients had previously received other treatments, including topical, intralesional, and systemic corticosteroids; oral retinoids; cyclosporin; and targeted systemic psoriasis monoclonal antibodies.

Two of the patients with severe disease achieved reduction to mild severity. Disease reactivation occurred in 2 of the patients following treatment discontinuation. The researchers reported that those with trachyonychia did not respond to the therapy.

No adverse events were reported during the study period. The medication required specialty compounding pharmacy preparation and was not typically covered by insurance.

Study limitations included small sample size, varying follow-up periods, and absence of a standardized scoring system for nail lichen planus severity.

The authors declared having no competing interests.