Methysergide-induced scleroderma-like changes of the legs

Abstract

Conflicts of interest: none declared. Sir, Methysergide is a semisynthetic ergot alkaloid ergometrine derivative, acting as a serotonin receptor antagonist, used in migraine prophylaxis. Common reported side‐effects include cardiac and arterial vasospastic symptoms and systemic fibrosis, mainly retroperitoneal. We describe the first case, to our knowledge, of methysergide‐associated scleroderma‐like changes of the legs. A 63‐year‐old woman presented with a 2‐month history of inflammatory oedema of the legs and feet. Her medical history included: (i) migraine treated with methysergide 1·65 mg daily, which she had taken continuously for more than 10 years; (ii) depression treated with lorazepam 5 mg daily for 5 years; (iii) breast carcinoma treated 3 years previously by tumorectomy, lymphadenectomy, chemotherapy and radiotherapy; since then, she had been taking tamoxifen 20 mg daily and had so far remained in remission; (iv) gastritis treated with esomeprazole 20 mg daily for 2 years; and (v) hypercholesterolaemia treated with pravastatin 20 mg daily for 2 years.