Methotrexate Injection Site Reactions: Case Report and Literature Review

This document reports a rare case of methotrexate (MTX) injection site reactions in a 77-year-old woman with eosinophilic fasciitis, a condition not previously associated with such reactions. The patient experienced red, inflamed lesions at injection sites on her thighs, which improved after switching to abdominal injections. A literature review identified only 5 other cases of MTX injection site reactions, mostly in patients with psoriasis and psoriatic arthritis, presenting as red patches or papules that improved with MTX discontinuation or topical steroids. The report underscores the rarity of these reactions and suggests that changing injection sites and using topical treatments can alleviate symptoms, highlighting the need for close monitoring and further research to establish consistent treatment protocols.