Would Transdermal Low Dose Naltrexone (LDN) Be Good at Controlling Cutaneous Mastocytosis?
Would transdermal LDN with Mast Cell stabilizer be better for controlling cutaneous mastocytosis than taking cetirizine and famotidine BID for the itching and rash with a flare would LDN be better than clobetasol?
To be candid with you I don't have any comparison data on these. It would be clinical experience. All I can do is say is try it on your patients and find out. It's not going to hurt them. What have you got to lose? You can use LDN in combination with the Mast Cell stabilizers. I think it's a very good combination to try for a lot of patients for symptoms in general. You can use the oral antihistamines along with the topical. There's really no reason why you couldn't use famotidine. You can use it simultaneously. You might want to layer your approach and see if it works and then maybe attempt taking one or both of them away one at a time to see if the patient still has symptomatic control.
In terms of is LDN better than clobetasol? Probably not. Short term but maybe long term I would say maybe it should be because if you think about what are you doing with the LDN you're attenuating the inflammatory process. With clobetasol you're temporarily shutting it down. It's just an immunosuppressant. You're suppressing the immune response. You're not down regulating the underlying pathology or the attenuation of the toll receptors. I think potentially the um topical Naltrexone or LDN would be a better choice for a long-term answer but I don't think there's any guarantee and I really have not, like I said, I've not seen any comparison data comparing the two. I really couldn't give you a solid answer on that. I apologize.