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Low-dose methotrexate-induced skin toxicity: Keratinocyte dystrophy as a histologic marker.
Delyon, Julie; Ortonne, Nicolas; Benayoun, Emmanuel; Moroch, Julien; Wolkenstein, Pierre; Sbidian, Emilie; Chosidow, Olivier.
Afiliação
  • Delyon J; Département de Dermatologie, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpitaux universitaires Henri Mondor, Créteil, France.
  • Ortonne N; Département de Pathologie, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpitaux universitaires Henri Mondor, Créteil, France.
  • Benayoun E; Département de Hématologie Biologique, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpitaux universitaires Henri Mondor, Créteil, France.
  • Moroch J; Département de Pathologie, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpitaux universitaires Henri Mondor, Créteil, France.
  • Wolkenstein P; Département de Dermatologie, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpitaux universitaires Henri Mondor, Créteil, France; Inserm, Centre d'Investigation Clinique 1430, Créteil, France; Equipe d'Accueil (EA) EpiDermE, Université Paris-Est Créteil, Créteil, France.
  • Sbidian E; Département de Dermatologie, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpitaux universitaires Henri Mondor, Créteil, France; Pôle Recherche Clinique Santé Publique, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpitaux universitaires Henri Mondor, Créteil, France; Inserm, Centre d'Investigatio
  • Chosidow O; Département de Dermatologie, Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpitaux universitaires Henri Mondor, Créteil, France; Inserm, Centre d'Investigation Clinique 1430, Créteil, France; Equipe d'Accueil (EA) EpiDermE, Université Paris-Est Créteil, Créteil, France.
J Am Acad Dermatol ; 73(3): 484-90, 2015 Sep.
Article em En | MEDLINE | ID: mdl-26190242
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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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Úlcera Cutânea / Queratinócitos / Metotrexato Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2015 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Úlcera Cutânea / Queratinócitos / Metotrexato Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2015 Tipo de documento: Article