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Updated: May 12, 2026
11:39
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Methotrexate toxicity presenting as cutaneous ulcerations on psoriatic plaques
Aslıhan Yonca Koçak1, Oğuzhan Koçak, Figen Aslan
1Department of Dermatology, Dumlup|nar University, Kütahya Evliya C elebi Education and Research Hospital, Kütahya, Turkey. aslihanyy@yahoo.com
Cutaneous and Ocular Toxicology
|March 30, 2013
Summary
Methotrexate (MTX) can cause severe side effects like skin necrosis in psoriasis patients. Unexpectedly, this patient experienced rapid healing of psoriatic lesions and ulcerations after MTX treatment.
Area of Science:
- Dermatology
- Pharmacology
Background:
- Methotrexate (MTX) is a widely used immunosuppressive drug for treating psoriasis.
- While effective, MTX carries a risk of significant toxicity, including dermatological adverse events.
Observation:
- A patient with psoriasis received a high daily dose of MTX (20 mg/day for 5 days).
- The patient developed severe adverse reactions: ulcerated and necrotic psoriatic plaques, oral erosions, and alopecia.
Findings:
- Despite the severe toxicity, the patient's psoriatic plaques and ulcerations demonstrated complete and rapid healing within two weeks.
- No recurrence of psoriasis was noted during a 6-month follow-up period.
Implications:
- This case highlights the complex and sometimes paradoxical response to MTX in psoriasis management.
- Further investigation may be warranted into the mechanisms underlying rapid healing following MTX-induced toxicity.
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