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[Acute methotrexate toxicity in psoriasis]
1Servicio de Dermatología, Hospital de Especialidades, CMN Siglo XXI, IMSS, México, D.F.
Abstract:
A 71-year-old man with psoriasis developed acute methotrexate toxicity after taking 10 mg daily on his own. A few days after, he showed painful erosions of psoriatic plaques and stomatitis. In addition to those mucocutaneous lesions, the clinical background includes bone marrow and intestinal involvement. The present clinical case underlies the relevance in selecting psoriasis patients regarding methotrexate treatment, following the particular guidelines.
Insights
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.