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Updated: Feb 12, 2026
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Diffuse Optical Spectroscopy for the Quantitative Assessment of Acute Ionizing Radiation Induced Skin Toxicity Using a Mouse Model
Published on: May 27, 2016
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Acute mucocutaneous methotrexate toxicity with marked tissue eosinophilia
Luis J Borda1, Andrew Ross1, Gabriel Villada1
1Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, Florida, USA.
BMJ Case Reports
|April 9, 2018
Summary
Methotrexate toxicity can cause skin erosions, sometimes with eosinophils, challenging typical presentations. This case highlights interface dermatitis with eosinophilic infiltrate in acute mucocutaneous methotrexate toxicity.
Area of Science:
- Dermatology
- Toxicology
- Oncology
Background:
- Methotrexate is a common chemotherapy and immunosuppressant.
- Mucocutaneous toxicity is a known side effect of methotrexate.
- Tissue eosinophilia is typically absent in methotrexate-induced mucocutaneous toxicity.
Observation:
- A 76-year-old woman with bullous pemphigoid on methotrexate developed oral and cutaneous erosions.
- Skin biopsy showed interface dermatitis with eosinophils, dyskeratotic cells, and pancytopenia.
- Erosions appeared during hospitalization following a daily methotrexate dosage adjustment.
Findings:
- The case presented acute methotrexate-induced mucocutaneous erosions with interface dermatitis and significant eosinophilia.
- Histopathology revealed irregular acanthotic epidermis, interface dermatitis, dyskeratotic cells, and a lymphocytic infiltrate with numerous eosinophils.
- This finding contrasts with the usual absence of eosinophils in methotrexate toxicity.
Implications:
- This case expands the histopathological spectrum of acute mucocutaneous methotrexate toxicity.
- It emphasizes that interface dermatitis with eosinophilic infiltrate can occur in this context.
- Recognizing this presentation is crucial for accurate diagnosis and management of methotrexate-induced toxicity.
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