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ÖZET: Psoriazis eritemli, skuamlı ve endure plaklarla karakterize,sık saçlı deri ve ekstansör yüzeyleri tutan kronik bir dermatozdur. Metotreksat psoriazis tedavisinde yaygın kullanılan sentetik bir folik asit analoğudur. Kanda nadiren toksik düzeylere ulaşarak şiddetli yan etkilere sebep olur. Bu durumda akut dönemde psoriatik plaklarda ülserasyon ve nekrozla karakterize cilt bulguları ortaya çıkar. Çoğu olguda sebep, ilacın yanlışlıkla haftalık rejim yerine daha kısa sürelerde veya bir defada çok miktarda alınmasıdır. Eşlik eden ileri yaş ve renal yetmezlik gibi nedenler de toksisiteye katkıda bulunur. Metotreksat toksisitesini erken dönemde tanımak ve hemen tedaviye başlamak açısından kutanöz bulgular oldukça önemlidir. Burada kliniğimize başvuran bir olgudan hareketle akut metotreksat toksisitesine yaklaşım ele alınacaktır.. ANAHTAR KELIMELER: kutanöz ülser, metotreksat, psoriazis ACUTE METHOTREXATE TOXICITY PRESENTING WITH CUTANEOUS ULCERATIONS ABSTRACT: Psoriasis is a chronic dermatosis characterized by erythematosus, scaly and indurated plaques which are most often located on scalp and extensor surfaces. Methotrexate is a synthetic folic asid analogue which is commonly used for the treatment of psoriasis. It rarely reaches toxic levels in the blood and causes severe adverse effects. In this situation, skin findings characterized by ulcerations and necrosis on psoriatic plaques emerge at the acute stage. In the most of the cases, the reason is misuse of the drug which is taking medicine at short intervals or too much during a treatment session instead of weekly regimen. Additional causes such as renal failure and older age contribute toxicity. Cutaneous findings are quite important to recognize methotrexate toxicity at the early stages and to start the treatment immediately. Herein, the approach to acute methotrexate toxicity will be discussed with reference to a case who is referred to our clinic. KEYWORDS: cutaneous ulceration, methotrexate, psoriasis
Psoriasis is a chronic dermatoz that is characterized by erythematic, squamous and durable plaques, often holding hairy skin and extender surfaces. Methotrexate is a synthetic folic acid analogue commonly used in the treatment of psoriasis. It rarely causes severe side effects by reaching toxic levels in the blood. In this case, in the acute period, skin signs characterized by ulceration and necrosis appear on the psoriatic plaques. In most cases, the cause is that the drug is accidentally taken in shorter periods or in a large amount at a time instead of a weekly regime. Causes like accompanying age and renal insufficiency also contribute to toxicity. Metotrexate toxicity is very important in the early stages of recognition and the immediate start of treatment. This is a chronic dermatosis characterized by erythematosus, scaly and indurated plaques which are most often located on scalp and extender surfaces. Methotrexate is a synthetic folic acid analogue which is commonly used for the treatment of psoriasis. It rarely reaches toxic levels in the blood and causes severe adverse effects. In this situation, skin findings characterized by ulcerations and necrosis on psoriatic plaques emerge at the acute stage. In most cases, the reason is misuse of the drug which is taking the medicine at short intervals or too much during a treatment session instead of the weekly regime. Additional causes such as renal failure and older age contribute to toxicity. Cutaneous findings are quite important to recognize methotrexate toxicity at the early stages and to start the treatment immediately. Herein, the approach to acute methotrexate toxicity will be discussed with reference to a case which is referred to our clinic. Keywords: cutaneous ulceration, methotrexate, psoriasis
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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