METHOTREXATE IN ALLERGIC CONTACT DERMATITIS: A RETROSPECTIVE CASE SERIES
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Keywords
allergic contact dermatitis, contact dermatitis, methotrexate
Abstract
Background: Methotrexate (MTX), a folate antimetabolite, is currently approved for and the majority of the currently available data delves into its application in psoriasis and atopic dermatitis, leaving its potential in allergic contact dermatitis (ACD) grossly understudied barring a few case series and studies showing promising results.
Objective: To evaluate the efficacy and tolerability of methotrexate in treating allergic contact dermatitis.
Methods: We performed a retrospective chart review of 14 patients who were diagnosed clinically and a positive patch test with allergic contact dermatitis and started on methotrexate therapy. Out of these, 4 patients were lost to follow up and a single patient had to discontinue methotrexate due to decrease in blood hemoglobin levels. Out of the 14 patients, 9 completed 3 months of methotrexate therapy and were evaluated. Demographic and treatment-associated data were collected from the medical records managed at the dermatology department of tertiary care centre.
Results: In the nine patients evaluated, the mean improvement of Eczema Area Severity Index (EASI) score was 72.23%. One patient achieved >90% improvement, while five others showed >70% reduction in EASI. The least response (45.63%) was noted in a patient with an 8-year disease history treated with 7.5 mg/week MTX. MTX was well tolerated in the majority; one patient discontinued therapy due to anaemia and was excluded from the evaluation.
Conclusion: Methotrexate is a relatively well-tolerated and effective treatment for allergic contact dermatitis with robust efficacy.
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Rajesh Kumar Soni
Assistant Professor, Department Of DVL, Ananta Medical College Campus, Rajsamand.
Manish Jain
Associate professor, Department of DVL, Ananta Institute of Medical Sciences and Research Centre, Rajsamand.
Punit Verma
Junior resident, Department of DVL, Ananta Institute of Medical Sciences and Research Centre, Rajsamand.
Manavi Kachhawa
Junior resident, Department of DVL, Ananta Institute of Medical Sciences and Research Centre, Rajsamand.