Work

Acute cutaneous adverse effects of methotrexate: A case report highlighting therapeutic challenges

Year: 2025

Type: article

Abstract: Methotrexate (MTX) is a commonly used antimetabolite for managing various autoimmune disorders and cancers. While it is generally well-tolerated at low doses, certain factors may predispose patients to significant toxicity. Here we present a case of 49-year-old male with advanced buccal mucosa squamous cell carcinoma who developed acute severe cutaneous toxicity following low dose of intravenous MTX therapy. After receiving two weekly doses, the patient experienced grade 4 oral mucositis and multiple erythematous plaques. This case highlights the importance of early recognition and prompt management of MTX toxicity, even at low doses, particularly in patients with risk factors such as prior antibiotic use and low serum albumin levels. • Methotrexate is generally well-tolerated at low doses, however we present a case of low dose of intravenous MTX therapy toxicity. • This case highlights the importance of early recognition and prompt management of MTX toxicity, even at low doses. • To detect MTX-induced organ toxicity at an early stage, monitoring of the blood cell count and liver enzymes is recommended at 1, 2, 3, 4, 5 and 12 weeks. Thereafter, 3 monthly follow up is recommended.

Source: Toxicology Reports

DOI: 10.1016/j.toxrep.2025.102108

Authors: Saarthak Miglani, Tanshi Daljit, Anurita Srivastava, Arun Kumar Rathi

Institution: Maulana Azad Medical College

Language: English

Topic: Chemotherapy-related skin toxicity

Subfield: Dermatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,530