Methotrexate Induced Stevens Johnson Syndrome: A Rare  Case Report

Arora, Surabhi; Abidi, Afroz; Fatima, Fariha; Hasan, Roohana; Rizvi, Darakhshan; Thadani, Anupriya

doi:10.24041/ejmr2018.95

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…Methotrexate is a folic acid antagonist that inhibits the reduction in folate supply and the proliferation of tissue cells [1]. Since the proliferation of malignant cells is greater than that of normal cells, Methotrexate can slow their proliferation without causing irreversible damage to healthy tissue hence the interest of its use in the treatment of several neoplasms.…”

Section: Introductionmentioning

confidence: 99%

Methotrexate Induced Stevens-Johnson Syndrome: Two Cases Reports

Masmoudi¹,

Baklouti²,

Siala³

et al. 2022

Clin Med Rev Case Rep

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Methotrexate induced Stevens-Johnson syndrome (SJS) is rare but life-threatening cutaneous reaction. This is a case report of two 14-year-old girls with methotrexate (MTX)-induced Stevens-Johnson syndrome (SJS). Both girls received chemotherapy with MTX in the treatment of osteosarcoma and then developed SJS. They showed cutaneous and mucosal erosions, macular and purplish rash, and ulceration in the cutaneous and mucosal areas. The full spectrum of all mucous membranesinvolved is less than 10% of the body surface area in the two patients.The diagnosis of SJS is based on clinical features and there are no universally accepted diagnostic criteria. Prompt withdrawal of causative drugs should be a priority and the re-exposure of culprit drug is not recommended.Corticosteroid at a dose of 1 mg / kg / day was administered to them and they both recovered from SJS. MTX is known as a drug that can induce SJS. So, it is rare but is not extremely rare.

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Section: Introductionmentioning

confidence: 99%

Methotrexate Induced Stevens-Johnson Syndrome: Two Cases Reports

Masmoudi¹,

Baklouti²,

Siala³

et al. 2022

Clin Med Rev Case Rep

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Methotrexate related cutaneous adverse drug reactions: a systematic literature review

Zuber¹,

Harikrishna²,

Vidhyashree³

et al. 2021

Journal of Basic and Clinical Physiology and Pharmacology

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Objectives Recently, there is an increased number of reports being published on Methotrexate (MTX) related cutaneous manifestations. We aimed to identify and critically appraise descriptive studies describing the MTX related skin manifestations, treatment approach, and their outcomes. Methodology An extensive literature search was performed in the PubMed, Embase, and Scopus databases from inception to April 2021 without any restrictions along with the bibliographic search of included studies, grey literature search, and a snowball search was performed in Google and Google Scholar to identify the relevant literature. Descriptive studies reporting MTX related cutaneous manifestations were considered for the review. The study selection, data extraction, and quality assessment were conducted by two independent reviewers and any disagreements were settled by consensus with the third reviewer. Results 31 out of 8,365 descriptive studies including 38 patients (22 females and 16 males) aged between 12 and 78 years prescribed for the management of rheumatoid arthritis, ankylosing spondylitis, and psoriasis were included in this review. Toxic epidermal necrolysis (TEN), papular eruption, vasculitis, erosions of psoriasis, ulcerated psoriatic plaques, local reactions, keratinocyte dystrophy, erythema multiforme, drug rash with eosinophilia and systemic symptoms, Steven Johnson syndrome and photosensitive dermatitis were the majority of MTX induced cutaneous reactions. Immediate withdrawal of MTX, providing appropriate care with anti-inflammatory, topical steroids, and supplementation with folic acid were reported to be effective for the management of the MTX related cutaneous manifestations. Conclusions Clinicians and healthcare professionals should be aware of possible acute cutaneous drug reactions induced by MTX to avoid further consequences and fatal conditions. Immediate withdrawal of MTX and supportive care were reported as an efficacious therapeutic management of acute cutaneous drug reactions. PROSPERO Registration number CRD42020220038.

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Methotrexate Induced Stevens Johnson Syndrome: A Rare Case Report

Cited by 2 publications

References 7 publications

Methotrexate Induced Stevens-Johnson Syndrome: Two Cases Reports

Methotrexate Induced Stevens-Johnson Syndrome: Two Cases Reports

Methotrexate related cutaneous adverse drug reactions: a systematic literature review

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