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[Acute methotrexate toxicity in psoriasis]
1Servicio de Dermatología, Hospital de Especialidades, CMN Siglo XXI, IMSS, México, D.F.
Gaceta Medica De Mexico
|December 22, 1999
Summary
A 71-year-old man experienced severe methotrexate toxicity from a 10 mg daily dose for psoriasis. This case highlights the need for careful patient selection and adherence to guidelines during methotrexate therapy for psoriasis.
Area of Science:
- Dermatology
- Pharmacology
- Toxicology
Background:
- Methotrexate is a common treatment for psoriasis.
- Patient self-administration of medication can lead to toxicity.
- Adherence to established treatment guidelines is crucial.
Observation:
- A 71-year-old male psoriasis patient self-administered 10 mg of methotrexate daily.
- The patient developed acute methotrexate toxicity.
- Clinical manifestations included painful psoriatic plaque erosions, stomatitis, bone marrow suppression, and intestinal involvement.
Findings:
- Acute methotrexate toxicity can manifest with severe mucocutaneous lesions.
- Systemic involvement, including bone marrow and gastrointestinal tract, can occur.
- Incorrect dosing or self-administration significantly increases toxicity risk.
Implications:
- This case underscores the importance of strict patient selection for methotrexate therapy in psoriasis.
- Physician and patient education on methotrexate dosage and administration is critical.
- Reinforces the necessity of adhering to established methotrexate treatment protocols to prevent adverse events.