Liver biopsies in psoriatics--complications and evaluation

Thirty-one liver biopsies were performed on twenty-two psoriatics on treatment or considered for treatment with methotrexate. Three developed serious morbidity after biopsy. Of twenty-one attempted pre-methotrexate biopsies, four were abnormal, and one failed. Five of ten post-methotrexate biopsies were abnormal. Histological abnormalities were mild and cirrhosis was not seen. Liver function tests were not found to be a reliable indicator of hepatic damage and it is felt that in spite of our relatively high complication rate, liver biopsy is a useful method for monitoring liver damage due to methotrexate and should be performed.