Successful treatment of refractory aquagenic pruritus with naltrexone

Journal of Cutaneous Medicine and Surgery
Sarah Ingber, Paul D Cohen

Abstract

Aquagenic pruritus is an intense prickling sensation that develops in affected individuals immediately after contact with water at any temperature. It is most commonly associated with polycythemia rubra vera. Common but often ineffective treatments include anticholinergics and antihistamines. Other moderately successful treatments include capsaicin cream, UVB phototherapy, and sodium bicarbonate bath water. In this case report we describe a 55-year-old female with severe itching following showers. Underlying causes were ruled out with a series of blood tests, a chest X-ray, and serum protein electrophoresis. After multiple treatment failures, her itching was relieved with naltrexone. 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.

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Citations

Oct 4, 2011·Indian Journal of Dermatology·C Shanmuga SekarSheja Jacob
May 14, 2010·Journal of the American Academy of Dermatology·Ngoc Quan PhanSonja Ständer
Jun 16, 2010·Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG·Tina HeitkemperSonja Ständer
Jun 29, 2016·Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete·C ZeidlerS Ständer
Feb 28, 2015·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Vijay Kumar AgrawalParul Mahajan
Jan 28, 2016·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Udismita BaruahHarish C Sachdeva
Feb 6, 2017·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Maryam Vasheghani FarahaniSayed Mahdi Marashi
May 16, 2019·Experimental Dermatology·Radomir Reszke, Jacek C Szepietowski
Dec 7, 2018·International Journal of Dermatology·Lamiaa Hamie, Jihane Abou-Rahal

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