Methotrexate toxicity presenting as ulceration of psoriatic plaques: a report of two cases
Agarwal, K.Kumar.; Nath, A.Kumar.; Thappa, D.Mohan.
Indian Journal of Dermatology Venereology and Leprology 74(5): 481-484
2008
ISSN/ISBN: 0378-6323 PMID: 19052409 Document Number: 622211
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.