Methotrexate in Dermatology

The 2007 document reviews methotrexate's use in dermatology, including its FDA-approved applications for psoriasis and cutaneous T-cell lymphoma, and off-label uses for other skin conditions. It details methotrexate's pharmacokinetics, dosing, side effects, and interactions, emphasizing the need for pre-treatment screening and regular monitoring, particularly for hepatotoxicity and bone marrow function. The document discusses guidelines for liver toxicity monitoring, including the use of PIIINP assays as per the Manchester guidelines, and notes the importance of considering drug interactions. It also suggests that future research into genetic polymorphisms may lead to more personalized methotrexate therapy by predicting patient responses and adverse effect risks. Despite potential side effects, methotrexate remains a cost-effective and essential medication in dermatology.