title: Mucocutaneous Ulcerations and Pancytopenia due to Methotrexate Overdose.
abstract: Methotrexate (MTX) is an antifolic drug used in the treatment of immune-mediated and neoplastic diseases. Initiation or dosage changes in MTX therapy can cause mucositis and bone marrow suppression. Skin lesions due to acute MTX toxicity are rare, but they serve as a herald for later-onset pancytopenia. Therefore, identification of those cutaneous lesions might help to initiate rescue strategies at an early stage. Here we describe a case with mucocutaneous ulcerations and pancytopenia due to overdosed MTX.
authors.affiliation: Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Katharina
authors.initials: K
authors.lastname: Knoll
authors.affiliation: Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Florian
authors.initials: F
authors.lastname: Anzengruber
authors.affiliation: Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cozzio
authors.affiliation: Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Lars E
authors.initials: LE
authors.lastname: French
authors.affiliation: Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Carla
authors.initials: C
authors.lastname: Murer
authors.affiliation: Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Navarini
keywords: Cutaneous side effects; Cytotoxicity; Drug reaction; Erosive stomatitis; Immunosuppression; Methotrexate toxicity; Mucocutaneous manifestation; Mucocutaneous symptoms; Poisoning; Side effects; Ulceration