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Low-dose methotrexate-induced vulvar edema: A case report.
Guifeng Jia1, Wei Chai, Zhiwei He
1Department of Gynecology and Obsterics, The First Hospital of Jilin University, Changchun, Jilin, China.
Medicine
|August 30, 2019
Summary
Low-dose methotrexate (MTX) can cause unusual vulvar edema and oral/scalp ulcerations. Early detection and prompt treatment are crucial for managing these methotrexate toxicity reactions.
Area of Science:
- Gynecology
- Dermatology
- Pharmacology
Background:
- Methotrexate (MTX), a folic acid antagonist, is a standard treatment for ectopic pregnancy.
- MTX toxicity commonly manifests as mucocutaneous damage, bone marrow suppression, and organ-specific toxicities.
- Vulvar edema is an uncommon adverse effect of low-dose MTX therapy.
Observation:
- A case report details a patient experiencing severe vulvar edema, oral ulceration, and scalp ulceration during low-dose MTX treatment for ectopic pregnancy.
- The patient presented with significant pain in the affected areas.
- Diagnosis was based on clinical presentation consistent with MTX-induced toxic reactions.
Findings:
- Treatment involved vulvar disinfection, oral rinses, and oral administration of compound glycyrrhizin.
- The patient's skin and mucosal lesions healed within 10 days of intervention.
- Complete resolution of vulvar edema, oral ulceration, and scalp ulceration was achieved.
Implications:
- This case highlights that even low-dose methotrexate can induce significant skin and mucosal injuries.
- Emphasizes the importance of timely detection and prompt management of MTX-related adverse events.
- Advocates for immediate discontinuation of the drug and symptomatic treatment to prevent severe complications.
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