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Updated: May 25, 2026
11:39
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Methotrexate toxicity presenting as ulcerated psoriatic plaques.
Su-ming Wong1, Yew Thong Chong, Suganthi Thevarajah
1Dermatology Unit, Department of Medicine, University Malaya, Kuala Lumpur, Malaysia. suming1@yahoo.com
The Australasian Journal of Dermatology
|February 8, 2012
Summary
Methotrexate toxicity can rarely cause psoriatic plaque erosions. This study highlights two cases where painful, ulcerated plaques signaled early methotrexate toxicity, prompting a review of associated risk factors.
Area of Science:
- Dermatology
- Rheumatology
- Toxicology
Background:
- Psoriatic plaques are a hallmark of psoriasis, an autoimmune condition.
- Methotrexate is a common immunosuppressive drug used for psoriasis and other autoimmune diseases.
- Methotrexate toxicity can manifest in various ways, but skin erosions are rare.
Observation:
- Two patients presented with painful, ulcerated psoriatic plaques.
- These ulcerated plaques were an early indicator of methotrexate toxicity.
- The clinical presentation was unusual, deviating from typical methotrexate side effects.
Findings:
- The development of painful, ulcerated psoriatic plaques can be an early sign of methotrexate toxicity.
- Identifying risk factors is crucial for recognizing and managing this rare adverse effect.
- This manifestation requires prompt medical attention to adjust treatment and prevent further complications.
Implications:
- Clinicians should consider methotrexate toxicity in patients with psoriasis who develop ulcerated plaques.
- Early recognition can prevent severe adverse events and allow for timely intervention.
- Further research into the specific mechanisms and risk factors is warranted to improve patient outcomes.
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