Methotrexate toxicity presenting as ulceration of psoriatic plaques: a report of two cases.
We describe two cases of methotrexate toxicity occurring due to inappropriate self-medication with the drug. The first patient was a 57-year-old man with plaque-type psoriasis on intermittent methotrexate therapy. He discontinued his medications for 2 months and had exacerbation of psoriasis for which he self-medicated with methotrexate following which he developed ulceration of the psoriatic plaques accompanied by bone marrow suppression. The second patient was a 68-year-old man with chronic plaque-type psoriasis for 20 years and was being treated with intermittent methotrexate for 15 years. He also self medicated with oral methotrexate 15 mg daily for 7 days for exacerbation of psoriasis and developed ulceration of the psoriatic plaques with bone marrow suppression and evidence of gastrointestinal erosions.
Agarwal
Kishan Kumar
KK
Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.
Nath
Amiya Kumar
AK
Thappa
Devinder Mohan
DM
D000368:Aged; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000009:adverse effects*; D008875:Middle Aged; D011565:Psoriasis / Q000139:chemically induced / Q000175:diagnosis*; D012883:Skin Ulcer / Q000139:chemically induced / Q000175:diagnosis*
D008727:Methotrexate