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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
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Methotrexate toxicity in psoriasis-A multicentric retrospective study.

Gautam Kumar Singh1, Devyani Sapra1, Amit Bahuguna1

  • 1Department of Dermatology, Base Hospital, Delhi Cantt, New Delhi, India.

Dermatologic Therapy
|September 2, 2022
PubMed
Summary
This summary is machine-generated.

Methotrexate (MTX) toxicity in psoriasis patients is often caused by overdosing. Early counseling and prompt treatment with folinic acid can improve outcomes, though severe cases may be fatal.

Keywords:
adverse drug reactionleucovorinmethotrexatepsoriasistoxicity

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Area of Science:

  • Dermatology
  • Pharmacology
  • Toxicology

Background:

  • Methotrexate (MTX) is a primary treatment for psoriasis.
  • Widespread availability and use of MTX in India lead to frequent overdosing and toxicity.
  • Limited comprehensive studies exist on MTX toxicity causes, manifestations, and management.

Purpose of the Study:

  • To evaluate risk factors, clinical features, and management of MTX toxicity in psoriasis patients.
  • To propose an optimal management protocol based on clinical experience.

Main Methods:

  • A multicentric, retrospective study of psoriasis patients treated for MTX toxicity over 5 years.
  • Data collected included demographics, drug history, clinical evaluation, lab parameters, management, and outcomes.

Main Results:

  • 21 psoriasis patients with MTX toxicity were analyzed.
  • Mucocutaneous ulcerations (95%) and hematological abnormalities (76%) were common.
  • Overdosing (66%) was the primary cause, often due to inadvertent use or self-medication.
  • Folinic acid treatment led to recovery in 85% within 7-14 days.
  • Three patients (14%) died despite treatment.

Conclusions:

  • Overdosing is a significant cause of MTX toxicity in psoriasis patients.
  • Patient counseling on MTX use and side effects is crucial.
  • Prompt medical attention and folinic acid are vital for managing MTX toxicity.