Low-dose methotrexate-induced skin toxicity: Keratinocyte dystrophy as a histologic marker  

Oleh:

Delyon, Julie ; Ortonne, Nicolas ; Benayoun, Emmanuel ; Moroch, Julien ; Wolkenstein, Pierre

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: JAAD: Journal of the American Academy of Dermatology (keterangan: ada di ClinicalKey) vol. 73 no. 03 (Sep. 2015), page 484–490 .
Topik: keratinocyte dystrophy; methotrexate; pancytopenia; psoriasis; skin toxicity; ulcers

Ketersediaan

Perpustakaan FK Nomor Panggil: J15.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Background Skin toxicity during low-dose methotrexate therapy is rare, ill described, and reported to have nonspecific histologic characteristics. Thus, misdiagnosis is common in patients with mucosal ulcers and/or skin erosions related to low-dose methotrexate. Objective We sought to describe the features of skin toxicity induced by low-dose methotrexate. Methods We evaluated the clinical and histologic features in 5 patients who experienced skin toxicity induced by low-dose methotrexate between 2011 and 2013. Results All 5 patients had acute mucosal ulcers, 4 had moderately abnormal blood cell counts, and 3 had skin erosions. In 3 patients, methotrexate dosage or dosing-schedule errors were identified. No other contributing factors (eg, renal dysfunction or interacting drugs) were identified. Mucocutaneous biopsy specimens consistently showed multiple dystrophic keratinocytes. Limitations We studied only 5 patients and obtained no sensitivity or specificity data on the diagnostic value of keratinocyte dystrophy. Conclusion Keratinocyte dystrophy may help to diagnose skin toxicity of low-dose methotrexate, even in the absence of known risk factors or methotrexate administration errors. Studies of the diagnostic performance of this histologic sign are needed.

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