Methotrexate Induced Toxic Epidermal Necrolysis: A Case Report

Methotrexate continues to be one of the most widely used systemic immunosuppressive agents in dermatology. We describe a case of low-dose methotrexate (MTX) toxicity in a patient with chronic plaque psoriasis occurring during long-standing methotrexate therapy. This case report emphasizes the fact that co-medications like NSAIDS may exacerbate MTX toxicity. This patient had a rare methotrexate-induced toxic epidermal necrolysis including cutaneous ulceration. Hence, careful consideration of concomitant medication is required to avoid drug interactions for safe long-term methotrexate treatment.