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[Acute methotrexate toxicity in psoriasis].

A Arévalo-López¹

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.

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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.

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