Complications in methotrexate treatment of psoriasis with particular reference to liver fibrosis.

@article{Ashton1982ComplicationsIM,
  title={Complications in methotrexate treatment of psoriasis with particular reference to liver fibrosis.},
  author={Richard Ashton and G. H. Millward-Sadler and J. E. G. White},
  journal={The Journal of investigative dermatology},
  year={1982},
  volume={79 4},
  pages={
          229-32
        }
}
All patients taking methotrexate for treatment of psoriasis over the past 5 yr have been reviewed. Thirty-eight patients have had pretreatment liver biopsies and at least 1 repeat liver biopsy. Of the 38, nine (24%) have developed significant liver fibrosis or cirrhosis, and have stopped treatment. The high incidence of fibrosis is attributed to synergism between methotrexate and other hepatotoxic factors, particularly alcohol, the use of a baseline biopsy to identify subsequent changes, and… Expand
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References

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TLDR
A review of the effects of folic acid antagonists in psoriasis has now been completed and three patients with cirrhosis and three of four with fibrosis had received significant amounts of oral methotrexate. Expand
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Fifty patients with psoriasis were evaluated prospectively and retrospectively for possible hepatotoxicity from methotrexate therapy. Liver function studies were not reliable indicators of pathologicExpand
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TLDR
Long-term methotrexate therapy is hepatotoxic in some individuals and should not be used when other modes of therapy are adequate, and liver function tests were poor indicators of hepatic pathologic conditions demonstrated on liver biopsy. Expand
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TLDR
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TLDR
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he results are reported of a prospective study of liver histological findings in twenty‐five patients with severe psoriasis subjected to liver biopsy before and at intervals after the onset ofExpand
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TLDR
Doubts are raised about the necessity of performing routine liver biopsies in those patients receiving methotrexate on an intermittent regimen because of the lack of reliable correlation between the liver function tests and the histologic findings. Expand
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TLDR
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TLDR
Factors contributing to cirrhosis in this study seem to be previous treatment with arsenic, a previous intake of alcohol, and lowered renal function. Expand
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TLDR
It appears that methotrexate, in the doses normally used to control psoriasis, may cause cirrhosis if treatment is prolonged and that liver biopsy is necessary for evaluation of liver damage in these patients. Expand
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