A prospective study of the effects of weekly oral methotrexate on liver biopsy

The results are reported of a prospective study of liver histological findings in twenty-five patients with severe psoriasis subjected to liver biopsy before and at intervals after the onset of treatment with methotrexate by an intermittent dosage schedule. The pre-methotrexate liver biopsy findings in forty-one other severe psoriatics are also summarized. Of the twenty-five treated patients, four showed a mild inflammatory cell infiltrate and two mild fibrosis before treatment. During treatment only one developed a grade 2 infiltrate and one other grade 2 fibrosis. None has developed cirrhosis. Where minor abnormalities developed, their fluctuating and reversible nature is demonstrated.