Kutanöz ülserler ile seyreden akut metotreksat toksisitesi

Psoriasis is a chronic dermatosis characterized by erythematosus, scaly and indurated plaques which are most often located on scalp and extensor surfaces. Methotrexate is a synthetic folic asid analogue which is commonly used for the treatment of psoriasis. It rarely reaches toxic levels in the blood and causes severe adverse effects. In this situation, skin findings characterized by ulcerations and necrosis on psoriatic plaques emerge at the acute stage. In the most of the cases, the reason is misuse of the drug which is taking medicine at short intervals or too much during a treatment session instead of weekly regimen. Additional causes such as renal failure and older age contribute toxicity. Cutaneous findings are quite important to recognize methotrexate toxicity at the early stages and to start the treatment immediately. Herein, the approach to acute methotrexate toxicity will be discussed with reference to a case who is referred to our clinic.