E3 PreliminaryPreliminaryPEM unclearPeer-reviewedMachine draft
Complete eradication of chronic long standing eczema and keratosis pilaris following treatment with dextroamphetamine sulfate.
Check, J H, Chan, S · Clinical and experimental obstetrics & gynecology · 2014
Quick Summary
This study describes two patients with ME/CFS who also had long-standing skin conditions (eczema and keratosis pilaris) that improved significantly when treated with dextroamphetamine, a stimulant medication. The authors suggest these skin problems may be related to an underactive nervous system that is also involved in ME/CFS, and that stimulant treatment may help both conditions.
Why It Matters
This study suggests a potential mechanistic link between sympathetic nervous system dysfunction, skin inflammation, and ME/CFS symptoms. If validated, identifying and treating autonomic nervous system dysfunction could address multiple co-occurring symptoms in ME/CFS patients, improving quality of life across multiple domains.
Observed Findings
- Patient 1: chronic eczema of 30 years duration improved following dextroamphetamine treatment
- Patient 2: chronic eczema and keratosis pilaris improved following dextroamphetamine treatment
- Migraine headaches improved in both patients after sympathomimetic therapy
- Chronic fatigue symptoms improved in both patients after sympathomimetic therapy
- Dermatologic improvement occurred in both male and female patients
Inferred Conclusions
- Eczema and keratosis pilaris may be manifestations of sympathetic nervous system hypofunction
- Symptoms across multiple body systems (neurological, immunologic, dermatologic) may respond to sympathomimetic amine therapy
- Sympatholytic dysfunction disorder is not restricted to females despite being more common in women
Remaining Questions
- Does dextroamphetamine or other sympathomimetics show efficacy in larger, controlled trials for ME/CFS-associated dermatologic conditions?
- What is the mechanism by which sympathetic hypofunction leads to chronic eczema and keratosis pilaris?
- Are there subgroups of ME/CFS patients with sympathetic dysfunction who would be most likely to benefit from this treatment?
What This Study Does Not Prove
This case report cannot establish causation or generalizability—two clinical observations do not prove that sympathomimetic therapy is effective for ME/CFS-related dermatologic conditions in broader populations. The improvement in skin symptoms may be coincidental, reflect placebo response, or result from unmeasured confounding factors. No control group or blinded assessment means bias and subjective reporting cannot be excluded.
Tags
Symptom:PainFatigue
Method Flag:Weak Case DefinitionNo ControlsSmall SampleExploratory Only
Metadata
- PMID
- 24779252
- Review status
- Machine draft
- Evidence level
- Early hypothesis, preprint, editorial, or weak support
- Last updated
- 8 April 2026
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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