Therapeutic Response and Adverse Effects of Methotrexate in Korean Patients with Dermatological Diseases.
- Author:
Young Jee KIM
1
;
Sook Jung YUN
;
Jee Bum LEE
;
Seong Jin KIM
;
Young Ho WON
;
Seung Chul LEE
Author Information
1. Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea. schul@chonnam.ac.kr
- Publication Type:Original Article
- Keywords:
Adverse effect;
Methotrexate;
Risk factor;
Therapeutic response
- MeSH:
Blood Cell Count;
Burns;
Dermatitis, Atopic;
Folic Acid;
Humans;
Liver Cirrhosis;
Liver Function Tests;
Methotrexate*;
Mycosis Fungoides;
Nausea;
Pityriasis Lichenoides;
Psoriasis;
Retrospective Studies;
Risk Factors;
Scleroderma, Localized;
Sensation;
Skin Diseases;
Vomiting
- From:Korean Journal of Dermatology
2014;52(4):237-243
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Methotrexate (MTX) is a synthetic folic acid analogue with anti-proliferative and anti-inflammatory properties, and is prescribed for a variety of dermatological disorders. OBJECTIVE: The aim of this study was to investigate the therapeutic responses, adverse effects, and risk factors of MTX for dermatological use. METHODS: We retrospectively evaluated age, gender, underlying diseases, initial and cumulative doses of MTX, treatment duration, physician's global assessment (PGA) scores, and adverse effects in 200 dermatological patients treated with MTX. RESULTS: Various dermatoses responded to MTX in the following order of effectiveness: psoriasis vulgaris, pustular psoriasis, pityriasis lichenoides, atopic dermatitis, mycosis fungoides, and morphea. Adverse effects of MTX were observed in 64 of the 200 patients (32%) as follows: elevated liver function tests (LFTs) in 36 (18%), nausea or vomiting in 22 (11%), complete blood count abnormalities in 5 (2.5%), and a burning sensation over the lesion in 4 (2%). All patients who showed abnormal LFTs were normalized after reducing or stopping MTX, and the mean time to normalization was 5.76 weeks. Liver fibrosis was not found. Risk factors for MTX-related adverse effects were old age (p=0.028), skin disease (p=0.018), high initial dose of MTX (p=0.023), and high cumulative dose of MTX (p=0.044). CONCLUSION: Among various dermatoses, psoriasis showed an excellent response to MTX with relatively acceptable safety in Koreans, but regular monitoring of MTX-related adverse effects is important. The risk factors for MTX-related adverse effects were old age, psoriasis, high initial dose, and high cumulative dose.
