There are many problems associated with the use of methotrexate in the treatment of psoriasis.
We will attempt to assist the clinician in resolving some of these problems.
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.
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.
Liver biopsy of patients on methotrexate for psoriasis may not be necessary.