Low-dose methotrexate-induced skin toxicity: Keratinocyte dystrophy as a histologic marker.
J Am Acad Dermatol
; 73(3): 484-90, 2015 Sep.
Article
en En
| MEDLINE
| ID: mdl-26190242
ABSTRACT
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.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Úlcera Cutánea
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Queratinocitos
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Metotrexato
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Am Acad Dermatol
Año:
2015
Tipo del documento:
Article
País de afiliación:
Francia