title: Focal skin toxicity related to methotrexate sparing psoriatic plaques.
abstract: Methotrexate (MTX) is an antimetabolite and antifolate drug used in the treatment of cancer and autoimmune diseases. MTX inhibits DNA synthesis by competitive inhibition of dihydrofolate reductase in immunologically active cells. It also decreases inflammation by other mechanisms. Cutaneous toxicity is usually dose-related and generally occurs when recommended guidelines are ignored or there is a decrease in renal excretion. Self-medication is a problem with unknown prevalence. Signs of MTX toxicity include bone marrow suppression, hepatotoxicity, and mucocutaneous toxicity. Painful erosions of psoriatic plaques and, less commonly, erosions in patients without psoriasis have been reported as an early sign of MTX toxicity. To our knowledge, this is the first case of skin toxicity related to MTX that affected the normal skin and spared the psoriatic plaques.
authors.forename: Teresa
authors.initials: T
authors.lastname: Truchuelo
authors.forename: Javier
authors.initials: J
authors.lastname: Alcántara
authors.forename: Carmen
authors.initials: C
authors.lastname: Moreno
authors.forename: Sergio
authors.initials: S
authors.lastname: Vano-Galván
authors.forename: Pedro
authors.initials: P
authors.lastname: Jaén
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D003875:Drug Eruptions / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D005260:Female; D005493:Folic Acid Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy*; D012651:Self Medication
chemical_list: D000964:Antimetabolites, Antineoplastic; D005493:Folic Acid Antagonists; D006633:Histamine Antagonists; D008727:Methotrexate