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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Systemic Methotrexate Treatment in 42 Children with Severe Plaque Psoriasis: A Retrospective Study in China
Zhaoyang Wang1, Yunliu Chen2, Xin Xiang2
1Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China, anjiuvsqishi@126.com.
Insights
Methotrexate (MTX) is effective for pediatric severe plaque psoriasis, showing significant PASI score improvements and PGA 0/1 in most patients. Close monitoring is essential due to potential side effects like elevated liver enzymes and infections.
Area of Science:
- Pediatric Dermatology
- Immunosuppressive Therapy
- Psoriasis Treatment
Background:
- Limited scientific evidence exists for methotrexate (MTX) use in pediatric severe plaque psoriasis.
- This study addresses the scarcity of data regarding MTX efficacy and safety in this population.
Purpose of the Study:
- To retrospectively evaluate the efficacy and safety of oral MTX in children with severe plaque psoriasis.
- Conducted in a single center in China.
Main Methods:
- Retrospective analysis of 42 children with severe plaque psoriasis treated with oral MTX.
- Efficacy assessed using Psoriasis Area and Severity Index (PASI), Physician Global Assessment (PGA), and Body Surface Area (BSA) scores.
- Safety and quality of life (CDLQI) were also monitored.
Main Results:
- Significant improvements in PASI, PGA, and BSA scores were observed by week 12.
- 80.6% achieved PASI75, 47.2% achieved PASI90, and 72.2% achieved PGA 0/1.
- Common side effects included elevated liver enzymes (28.6%) and infections (28.6%); relapse occurred in 30%.
Conclusions:
- Oral methotrexate is an effective and safe treatment option for children with severe plaque psoriasis.
- Adequate patient monitoring is crucial for managing potential adverse events.
- MTX demonstrated sustained efficacy and improved quality of life in pediatric patients.
Background:
The scientific evidence of methotrexate (MTX) in children with severe plaque psoriasis is scarce.
Objectives:
To retrospectively evaluate the efficacy and safety of oral MTX in children with severe plaque psoriasis in a single center in China.
Methods:
We enrolled 42 children with severe plaque psoriasis who were administrated MTX. Efficacy was evaluated by the psoriasis area and severity index (PASI) score, physician global assessment (PGA) score, and body surface area (BSA) score. The Children's Dermatology Life Quality Index (CDLQI) score and safety data were recorded.
Results:
Among 42 children (22 males, 20 females), the mean age was 11.2 years old. The initial weight-based dosage of oral MTX ranged from 0.1 to 0.3 mg/kg weekly. Overall, 80.6 and 47.2% of patients achieved PASI75 (at least 75% improvement from baseline in PASI score) and PASI90 (at least 90% improvement from baseline in PASI score) at week 12, respectively. 72.2% of patients achieved PGA 0/1 at week 12. BSA and PGA scores significantly decreased from baseline from week 4, accompanied by CDLQI score improvement from week 8. The steady effect of MTX could be reached at week 16. Elevated liver enzymes (28.6%) and infections (28.6%) were the most common side effects. Relapse was recorded in 9 (30.0%) of 30 patients, and the mean posttherapy disease-free interval was 7.2 months.
Conclusions:
MTX is an effective and safe option for children with severe plaque psoriasis with adequate monitoring.
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