Use of methotrexate in the treatment of psoriasis and other dermatological disorders

Abstract

Following the demonstration by Rees et al. that the skin disease psoriasis is quite often responsive to treatment with methotrexate (MTX) other investigators began to examine its use in a wide variety of benign and malignant cutaneous diseases [1-6] (Tab. 1). Most of these diseases have been shown to arise as a result of severe inflammation, cellular hyperproliferation, tissue hyperplasia, or a combination of these. Because psoriasis is the most common of this group of diseases, estimated to occur in 1-2% of western European populations [7], much of the discussion on the use of MTX in skin disease will be given to MTX and its use in psoriasis. Table 1 Skin diseases in which methotrexate has been found useful Hyperproliferative Malignancies Vasculitis Systemic connective tissue diseases Bullous diseases Inflamm atory skin diseases - Psoriasis and psoriatic arthritis - Pityriasis rubra pilaris - Epidermolytic hyperkeratosis - Lamellar ichthyosis - Cutaneous T-cell lymphoma (mycos is fungoides and Sezary’s syndrome) - Polyarteri tis nodosa (cutaneous and systemic) - Wegener’s granulomatosis - Dermatomyositis - Pemphigus - Pemphigoid - Pityriasis Iichenoides et varioliformis (Mucha-Habermann disease) - Sarcoidosis