Low-dose methotrexate-induced ulcerated psoriatic plaques: A rare case

Low-dose methotrexate is an effective and safe management for extensive and severe psoriasis. It may cause adverse reactions ranging from trivial to life threatening. Among them, hepatotoxicity and pancytopenia are the common serious side effects, whereas painful ulceration of psoriatic plaques as an early cutaneous manifestation of low-dose methotrexate toxicity has rarely been reported.1, 2, 3, 4, 5 Here, we describe a case of psoriatic plaque ulceration induced by low-dose methotrexate and highlight the risk factors and possible mechanisms of toxicity.