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KMID : 0363220140520040237
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Korean Journal of Dermatology
2014 Volume.52 No. 4 p.237 ~ p.243
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Therapeutic Response and Adverse Effects of Methotrexate in Korean Patients with Dermatological Diseases
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Kim Young-Jee
Yun Sook-Jung
Lee Jee-Bum
Kim Seong-Jin
Won Young-Ho
Lee Seung-Chul
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Abstract
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Background: Methotrexate (MTX) is a synthetic folic acid analogue with anti-proliferative and anti-inflammatoryproperties, and is prescribed for a variety of dermatological disorders. Objective: The aim of this study was to investigate the therapeutic responses, adverse effects, and risk factors ofMTX for dermatological use.
Methods: We retrospectively evaluated age, gender, underlying diseases, initial and cumulative doses of MTX,treatment duration, physician’s global assessment (PGA) scores, and adverse effects in 200 dermatological patientstreated with MTX.
Results: Various dermatoses responded to MTX in the following order of effectiveness: psoriasis vulgaris, pustularpsoriasis, pityriasis lichenoides, atopic dermatitis, mycosis fungoides, and morphea. Adverse effects of MTX wereobserved in 64 of the 200 patients (32%) as follows: elevated liver function tests (LFTs) in 36 (18%), nausea orvomiting in 22 (11%), complete blood count abnormalities in 5 (2.5%), and a burning sensation over the lesion in4 (2%). All patients who showed abnormal LFTs were normalized after reducing or stopping MTX, and the meantime to normalization was 5.76 weeks. Liver fibrosis was not found. Risk factors for MTX-related adverse effectswere old age (p=0.028), skin disease (p=0.018), high initial dose of MTX (p=0.023), and high cumulative dose ofMTX (p=0.044).
Conclusion: Among various dermatoses, psoriasis showed an excellent response to MTX with relatively acceptablesafety in Koreans, but regular monitoring of MTX-related adverse effects is important. The risk factors for MTXrelatedadverse effects were old age, psoriasis, high initial dose, and high cumulative dose.
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KEYWORD
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Adverse effect, Methotrexate, Risk factor, Therapeutic response
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