Hepatotoxicity is a major concern with methotrexate (MTX) therapy for psoriasis. Guidelines to help ensure safe use of MTX in this patient population are revisited periodically as new data become available. Much focus has been dedicated to establishing pre-treatment and monitoring protocols to detect MTX-induced hepatic injury. Here we review past and current guidelines, risk factors, population characteristics, and surveillance techniques with regard to MTX hepatotoxicity in psoriasis patients.
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