Reactivation of scabies rash by methotrexate

Burrows, D.; Bridges, J. M.; Morris, T. C. M.

doi:10.1111/j.1365-2133.1975.tb06745.x

Cited by 11 publications

(2 citation statements)

References 6 publications

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“…The older literature is contradictory with reports of both flare of scabies with methotrexate 1 as well as its effective use for extensive, recalcitrant crusted scabies. 2 The recurrent development of crusted scabies in our patient while on weekly methotrexate supports the former contention.…”

mentioning

confidence: 95%

Severe, Recurrent Crusted Scabies in a Psoriatic on Methotrexate

Khurana

Bathula²,

Muddebihal³

et al. 2022

The American Journal of Tropical Medicine and Hygiene

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confidence: 95%

Severe, Recurrent Crusted Scabies in a Psoriatic on Methotrexate

Khurana

Bathula²,

Muddebihal³

et al. 2022

The American Journal of Tropical Medicine and Hygiene

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“…The usual regimen consists of 2 doses of ivermectin 200 µg/kg of body weight given 2 weeks apart in conjunction with topical agents. As an interesting aside, methotrexate was once reported to be efficacious in crusted scabies but can also reactivate the condition 16,17 …”

mentioning

confidence: 99%

Diagnostic Dilemma: Crusted Scabies Superimposed on Psoriatic Erythroderma in a Patient With Acquired Immunodeficiency Syndrome

Fuchs

Sapadin

Phelps

et al. 2007

Skinmed

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A 45-year-old man with AIDS presented with extensive erythema and scaling involving the face, trunk, and upper and lower extremities, and mild nail dystrophy. The patient had been diagnosed with psoriasis 2 years previously, and at the time of presentation was using emollients and topical corticosteroid creams with little improvement. He was receiving zidovudine, lamivudine, trimethoprim/sulfamethoxazole, acyclovir, rifabutin, and hydroxyzine. Pertinent laboratory data included CD4 lymphocytes (10 cells/mm(3)), viral load (32,000 copies per mL) white blood cell count (3.4 x 10(3)/microL), hemoglobin (13.5 g/dL), and platelets (204 x 10(3)/microL). Because of the extensive eruption and lack of response to topical agents, the patient was started on acitretin 25 mg daily. The patient had shown no signs of improvement 4 weeks later and was noted to have brownish gray crusted plaques involving the beard area, neck, upper part of the back, arms, trunk, genitals, and thighs in addition to his erythroderma (Figure 1 and Figure 2). Microscopic examination of scales from the upper part of the back revealed numerous scabies mites and eggs. He was then treated with lindane shampoo on the scalp and beard area and permethrin 5% cream to the body. The patient returned 2 weeks later with some improvement after thrice-weekly applications of this regimen; however, scrapings from the trunk once again revealed live scabies mites. Microscopic examination of scales that had fallen on the examination table revealed multiple mites and eggs. The patient was then given permethrin 5% cream, which he applied 3 times a week for 2 weeks, and 1 dose of oral ivermectin, 200 micro/kg. This resulted in a marked decrease in crusting and scaling. With resolution of the scabies lesions, the patient displayed marked erythema and scaling of the trunk and extremities consistent with generalized psoriasis (Figure 3). Treatment with acitretin resulted in gradual resolution of the erythroderma. A few months later, the patient presented with nodules on the upper part of the back, which on biopsy revealed a scabies mite (Figure 4).

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Methotrexate Reactivation of Sunburn Reaction

Korossy¹

1981

Arch Dermatol

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Reactivation of scabies rash by methotrexate

Abstract: SUMMARY A 13‐year‐old female was on maintenance therapy for acute lymphoblastic leukaemia. On three occasions she received methotrexate orally and each time this was associated with reactivation of scabies rash. The mechanisms for this phenomenon are discussed.

Cited by 11 publications

References 6 publications

Severe, Recurrent Crusted Scabies in a Psoriatic on Methotrexate

Severe, Recurrent Crusted Scabies in a Psoriatic on Methotrexate

Diagnostic Dilemma: Crusted Scabies Superimposed on Psoriatic Erythroderma in a Patient With Acquired Immunodeficiency Syndrome

Methotrexate Reactivation of Sunburn Reaction

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