Fulminant hepatic failure after methotrexate and PUVA therapy for psoriasis.
Acute hepatic failure developed after 8-methoxypsoralen and ultraviolet irradiation for psoriasis in a patient with prior methotrexate-induced cirrhosis. Review of the literature and the temporal relationship between 8-methoxypsoralen and hepatic injury in our patient suggests it may be a direct hepatotoxin. In our report, submassive necrosis superimposed on cirrhosis appears to have produced hepatic failure.
Markin
R S
RS
Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha 68198-3135.
Donovan
J P
JP
Shaw
B W
BW
Zetterman
R K
RK
D006501:Hepatic Encephalopathy / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000139:chemically induced / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D009336:Necrosis; D011701:PUVA Therapy / Q000009:adverse effects*; D011565:Psoriasis / Q000188:drug therapy*
D008727:Methotrexate