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Year : 2018  |  Volume : 9  |  Issue : 5  |  Page : 328-330

Methotrexate cutaneous toxicity following a single dose of 10 mg in a case of chronic plaque psoriasis: A possible idiosyncratic reaction

1 Department of Dermatology, Dr Ram Manohar Lohia Hospital, New Delhi, India
2 Department of Pathology, Dr Ram Manohar Lohia Hospital, New Delhi, India

Correspondence Address:
Aastha Gupta
Department of Dermatology, Dr Ram Manohar Lohia Hospital, New Delhi - 110001
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/idoj.IDOJ_316_17

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Low-dose methotrexate is a well-tolerated and inexpensive systemic immunosuppressive agent used commonly in dermatology. However, several adverse events such as pancytopenia, pneumonitis, mucositis, and cutaneous ulcerations may develop during acute toxicity with dose-dependent or idiosyncratic mechanisms. Risk factors for methotrexate toxicity include advanced age, hypoalbuminemia, renal dysfunction, and concomitant drugs increasing the level of methotrexate in the body. We present a case of methotrexate toxicity presenting with classical features along with mucocutaneous side-effects, such as ulceration of psoriatic plaques and acral erythema, following a single dose of methotrexate.

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