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Toxic rash associated with high dose methotrexate therapy.
R Bell1, J R Sullivan, J G Burdon
1Department of Haemato-Oncology, Royal Melbourne Hospital, Victoria, Australia.
Clinical and Experimental Pharmacology & Physiology. Supplement
|January 1, 1979
Summary
High-dose methotrexate therapy can cause various skin rashes in patients. These methotrexate-associated rashes appear to be toxic in nature, rather than allergic, and are linked to higher drug doses.
Area of Science:
- Dermatology
- Oncology
- Pharmacology
Background:
- Methotrexate (MTX) is a chemotherapy agent used in various cancers and autoimmune diseases.
- Skin rashes are a frequently reported side effect of high-dose MTX therapy.
- The exact mechanism and incidence of MTX-induced rashes require further elucidation.
Purpose of the Study:
- To investigate the nature and potential mechanisms of skin rashes associated with high-dose methotrexate therapy.
- To document the types of rashes observed and their relationship to MTX dosage and toxicity.
Main Methods:
- Observational study of thirteen patients treated with high-dose methotrexate.
- Clinical documentation of observed skin rashes and associated toxic manifestations.
- Analysis of rash recurrence in relation to subsequent MTX treatment courses.
Main Results:
- Fifteen distinct rashes were observed in thirteen patients receiving high-dose MTX.
- The observed rashes included perifolliculitis, erythema, maculopapular eruptions, and desquamation.
- Rashes did not recur with subsequent MTX courses and were associated with other toxicities, suggesting a toxic mechanism.
Conclusions:
- The skin rashes associated with high-dose methotrexate therapy are likely a toxic phenomenon.
- The incidence and specific types of MTX-induced rashes warrant further investigation.
- Understanding the toxic mechanism can aid in managing MTX-related dermatological side effects.