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Updated: Jun 27, 2026

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Methotrexate toxicity presenting as ulceration of psoriatic plaques: a report of two cases
Kishan Kumar Agarwal1, Amiya Kumar Nath, Devinder Mohan Thappa
1Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.
Abstract:
We describe two cases of methotrexate toxicity occurring due to inappropriate self-medication with the drug. The first patient was a 57-year-old man with plaque-type psoriasis on intermittent methotrexate therapy. He discontinued his medications for 2 months and had exacerbation of psoriasis for which he self-medicated with methotrexate following which he developed ulceration of the psoriatic plaques accompanied by bone marrow suppression. The second patient was a 68-year-old man with chronic plaque-type psoriasis for 20 years and was being treated with intermittent methotrexate for 15 years. He also self medicated with oral methotrexate 15 mg daily for 7 days for exacerbation of psoriasis and developed ulceration of the psoriatic plaques with bone marrow suppression and evidence of gastrointestinal erosions.
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