METHOTREXATE TOXICITY-INDUCED EPIDERMAL NECROSIS

Methotrexate is a folate antagonist that is used for a wide range of medical conditions such as Rheumatoid arthritis, Seronegative arthritis and certain malignancies. Low-dose methotrexate toxicity is usually well tolerated but certain factors such as hypoalbuminemia, renal dysfunction and concomitant use of certain drugs may predispose the patient to methotrexate toxicity with methotrexate. A woman in her late 50s who is on methotrexate for rheumatoid arthritis presented with multiple skin lesions, and oral ulcers. The patient had pancytopenia with agranulocytosis. The patient was started on folinic acid, and the patient had rapid resolution of skin lesions and pancytopenia.