Methotrexate in childhood psoriasis

We treated childhood psoriasis with methotrexate (MTX) in seven children (4 boys, 3 girls) over 7.5 years. Their ages and duration of disease varied from 3.5 to 16 years (mean 12.14 yrs) and 4.8 months to 5 years (mean 2.2 yrs), respectively. Psoriatic erythroderma was seen in three patients, generalized pustular psoriasis in two, recalcitrant psoriasis and psoriatic arthropathy in one each. Pre-MTX liver biopsy performed in 4 children showed grade I changes. Methotrexate was given in a single weekly oral dose of 3.75 to 25 mg (mean 16.6 mg). The duration of treatment necessary to control the disease varied from 6 to 10 weeks (mean 7.9 wks). Total duration of MTX therapy was 31.2 to 46.4 weeks (mean 38.8 wks). Posttherapy disease-free interval ranged between 14.4 and 16.8 weeks (mean 15.5 wks). Follow-up after withdrawal of MTX was 16 to 28 weeks (mean 22.3 wks). Total cumulative MTX dose ranged from 390 to 960 mg (mean 683.6 mg). Side effects were nausea and vomiting in three patients.