Open AccessMethotrexate cutaneous toxicity following a single dose of 10 mg in a case of chronic plaque psoriasis: A possible idiosyncratic reaction
Author(s) -
Aastha Gupta,
Kabir Sardana,
Minakshi Bhardwaj,
Ajeet Singh
Publication year - 2018
Publication title -
indian dermatology online journal
Language(s) - English
Resource type - Journals
eISSN - 2249-5673
pISSN - 2229-5178
DOI - 10.4103/idoj.idoj_316_17
Subject(s) - medicine , methotrexate , mucositis , mucocutaneous zone , dermatology , psoriasis , toxicity , erythema , adverse effect , toxic epidermal necrolysis , concomitant , pancytopenia , hypoalbuminemia , pharmacology , gastroenterology , bone marrow , disease
Low-dose methotrexate is a well-tolerated and inexpensive systemic immunosuppressive agent used commonly in dermatology. However, several adverse events such as pancytopenia, pneumonitis, mucositis, and cutaneous ulcerations may develop during acute toxicity with dose-dependent or idiosyncratic mechanisms. Risk factors for methotrexate toxicity include advanced age, hypoalbuminemia, renal dysfunction, and concomitant drugs increasing the level of methotrexate in the body. We present a case of methotrexate toxicity presenting with classical features along with mucocutaneous side-effects, such as ulceration of psoriatic plaques and acral erythema, following a single dose of methotrexate.