Methotrexate Induced Toxic Epidermal Necrolysis: A Case Report
Abstract
Methotrexate continues to be one of the most widely used systemic immunosuppressive agents in dermatology. We describe a case of low-dose methotrexate (MTX) toxicity in a patient with chronic plaque psoriasis occurring during long-standing methotrexate therapy. This case report emphasizes the fact that co-medications like NSAIDS may exacerbate MTX toxicity. This patient had a rare methotrexate-induced toxic epidermal necrolysis including cutaneous ulceration. Hence, careful consideration of concomitant medication is required to avoid drug interactions for safe long-term methotrexate treatment.
Downloads
References
Sancheti K, Podder I, Gharami RC. Toxic epidermal necrolysis like reaction due to low-dose methotrexate in a case of cutaneous lupus erythematosus: A rare occurrence. Indian J Dermatol 2016; 61(1): 102-4. Available from: http://www.e-ijd.org/text.asp2016/61/1/102/17405.
Tiwari P, Panik R, Bhattacharya A, Ahirwar D, Chandy A. Toxic epidermal necrolysis: an update. Asian Pac J Trop Dis 2013; 3(2): 85-92.doi: https://dx.doi.org/10.1016%2FS2222-1808(13)60051-1.
Weidmann A, Foulkes AC, Kirkham N, Reynolds NJ. Methotrexate toxicity during treatment of chronic plaque psoriasis: a case report and review of the literature. Dermatology and therapy 2014;4(2):145-156. doi: https://doi.org/10.1007/s13555-014-0056-z.
Tazi I, Madani A, Zafad S, Harif M, Quessar A, Benchekroun S. Methotrexate-induced toxic epidermal necrolysis: A case report. Int J Med Med Sci. 2009;1(4):99–101. Available online at http://www.academicjournals.org/IJMMS.
Naldi L, Griffiths CEM. Traditional therapies in the management of moderate to severe chronic plaque psoriasis: An assessment of the benefits and risks. Br J Dermatol. 2005;152(4):597–615. doi: https://doi.org/10.1111/j.1365-2133.2005.06563.x.
OAI - Open Archives Initiative
