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Updated: May 12, 2026

Continuous Fluorescence-Based Endonuclease-Coupled DNA Methylation Assay to Screen for DNA Methyltransferase Inhibitors
06:07

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Published on: August 5, 2022

Methotrexate.

G D Weinstein

    Annals of Internal Medicine
    |February 1, 1977
    PubMed
    Summary
    This summary is machine-generated.

    Methotrexate, a folic acid antagonist, is a safe and effective systemic treatment for severe psoriasis, despite a small risk of liver damage. Its use may decrease with the advent of photochemotherapy.

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    Published on: May 10, 2024

    Area of Science:

    • Dermatology
    • Pharmacology

    Background:

    • Folic acid antagonists like methotrexate have been used for severe psoriasis for 25 years.
    • Methotrexate, FDA-approved 5 years ago, is used by approximately 25,000 psoriatic patients annually.
    • While generally safe in chronic low doses for psoriasis, methotrexate carries a risk of significant hepatotoxicity.

    Purpose of the Study:

    • To review the efficacy and safety of methotrexate in treating severe psoriasis.
    • To discuss the use of methotrexate in other dermatologic conditions.
    • To consider the impact of new treatments on methotrexate use.

    Main Methods:

    • Review of existing literature on methotrexate for psoriasis and other dermatologic conditions.
    • Analysis of methotrexate's safety profile, particularly hepatotoxicity.
    • Discussion of emerging photochemotherapy treatments.

    Main Results:

    • Methotrexate demonstrates good to excellent results in most psoriasis patients.
    • Hepatotoxicity is a known, though limited, risk associated with methotrexate therapy.
    • Methotrexate shows effectiveness in other dermatologic conditions like mycosis fungoides and dermatomyositis.

    Conclusions:

    • The benefits of methotrexate for severe psoriasis generally outweigh the small risk of liver damage.
    • Photochemotherapy (psoralen and ultraviolet light) may reduce the need for methotrexate in moderate to severe psoriasis.
    • Methotrexate remains a valuable treatment option for psoriasis and other dermatologic conditions, pending further research and regulatory approval for off-label uses.