Topical methotrexate in dermatology: a review of the literature.


Journal

The Journal of dermatological treatment
ISSN: 1471-1753
Titre abrégé: J Dermatolog Treat
Pays: England
ID NLM: 8918133

Informations de publication

Date de publication:
Feb 2022
Historique:
pubmed: 16 5 2020
medline: 16 2 2022
entrez: 16 5 2020
Statut: ppublish

Résumé

Systemic methotrexate (MTX) is a useful treatment for many dermatologic conditions, however, the risk of adverse events prevents its use in patients with minimal or localized disease. Topical application of MTX may be an option to avoid the systemic adverse effects of oral MTX. To assess what is known about the efficacy and safety of topical methotrexate. A search on Pubmed was conducted. There were no limits on publication date. A total of 963 articles were discovered. Using our exclusion criteria, 916 articles were excluded; 47 articles were used for full text assessment. Topical MTX has been used primarily in psoriasis but also in mycosis fungoides, lymphomatoid papulosis, and oral precancerous lesions. Optimal delivery system and formulation for adequate penetration is still under investigation. The quality of evidence for the utility of topical methotrexate in psoriasis is good, however, for other dermatologic diseases, the quality is poor. Topical MTX with improved delivery methods may be a viable tool against certain localized dermatologic conditions for patients who do not tolerate oral MTX. Further double-blinded randomized controled studies are needed to substantiate the utility of topical methotrexate.

Sections du résumé

BACKGROUND BACKGROUND
Systemic methotrexate (MTX) is a useful treatment for many dermatologic conditions, however, the risk of adverse events prevents its use in patients with minimal or localized disease. Topical application of MTX may be an option to avoid the systemic adverse effects of oral MTX.
OBJECTIVE OBJECTIVE
To assess what is known about the efficacy and safety of topical methotrexate.
METHODS METHODS
A search on Pubmed was conducted. There were no limits on publication date.
RESULTS RESULTS
A total of 963 articles were discovered. Using our exclusion criteria, 916 articles were excluded; 47 articles were used for full text assessment. Topical MTX has been used primarily in psoriasis but also in mycosis fungoides, lymphomatoid papulosis, and oral precancerous lesions. Optimal delivery system and formulation for adequate penetration is still under investigation.
CONCLUSION CONCLUSIONS
The quality of evidence for the utility of topical methotrexate in psoriasis is good, however, for other dermatologic diseases, the quality is poor. Topical MTX with improved delivery methods may be a viable tool against certain localized dermatologic conditions for patients who do not tolerate oral MTX. Further double-blinded randomized controled studies are needed to substantiate the utility of topical methotrexate.

Identifiants

pubmed: 32412810
doi: 10.1080/09546634.2020.1770170
doi:

Substances chimiques

Dermatologic Agents 0
Methotrexate YL5FZ2Y5U1

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

512-517

Auteurs

Divya Aickara (D)

Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.

Arjun M Bashyam (AM)

Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.

Rita O Pichardo (RO)

Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.

Steven R Feldman (SR)

Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Department of Dermatology, University of Southern Denmark, Odense, Denmark.

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Classifications MeSH