There are many problems associated with the use of methotrexate in the treatment of psoriasis.
Objective:
We will attempt to assist the clinician in resolving some of these problems.
Methods:
This article is a summary of a Round Table Discussion on methotrexate held at the Canadian Dermatology Association meeting at Whistler, BC, July 1995; of a Continuing Medical Education meeting on methotrexate at Langdon Hall, Cambridge, ON, May 1996; and our review of the pertinent literature.
Results:
We recommend routine folic acid supplementation in patients receiving methotrexate. A baseline pretreatment liver biopsy is probably not indicated in patients without clinical or laboratory evidence of liver disease; and patients on 15 mg or less of methotrexate per week with normal liver function may not need liver biopsy.
Conclusion:
Liver biopsy of patients on methotrexate for psoriasis may not be necessary.
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