Methotrexate in the treatment of psoriasis

Methotrexate is an important drug in the armamentarium available to physicians to treat patients with moderate to severe psoriasis. The drug has a 40-year track record and has proven to be effective in cases in psoriasis that are refractory to other intense forms of treatment. While it has proven efficacy, methotrexate also has the potential for both acute and chronic toxicity. Patients must be carefully selected and the drug administered according to specific guidelines to guard against the development of serious side effects. Methotrexate is best used by individuals very familiar with psoriasis and equally well-versed in the complexities of managing patients on antimetabolite therapy.