Dermatologic uses of methotrexate in children: indications and guidelines

Although methotrexate is frequently employed as an antimetabolic chemotherapeutic agent for childhood cancer, it is rarely used for dermatologic disorders in children. In the pediatric patient whose skin disease is recalcitrant to more conservative treatment, a trial of methotrexate is often appropriate. There are few reports of the drug's use for skin disorders in childhood upon which to base rational therapeutic management, however. In setting guidelines for use in children, we must consider pharmacokinetic studies and methotrexate toxicity observed in managing pediatric cancer.