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" Cutaneous erosions: a herald for impending pancytopenia in methotrexate toxicity "
Shiver, Mallory B; Hall, Lauren A; Conner, Kelly B; Brown, Grace E; Cheung, Wang L; Wirges, Marla L
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AL
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| Record Number
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923717
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LA46k975h8
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| Language of Document
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English
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| Main Entry
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Shiver, Mallory B; Hall, Lauren A; Conner, Kelly B; Brown, Grace E; Cheung, Wang L; Wirges, Marla L
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| Title & Author
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Cutaneous erosions: a herald for impending pancytopenia in methotrexate toxicity [Article]\ Shiver, Mallory B; Hall, Lauren A; Conner, Kelly B; Brown, Grace E; Cheung, Wang L; Wirges, Marla L
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| Title of Periodical
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Dermatology Online Journal
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20/7
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| Date
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2014
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| Abstract
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Psoriatic plaque erosion is a rare toxic side effect of low-dose methotrexate (LDMTX) that has been reported during the treatment of psoriasis and described as a herald for impending pancytopenia. Fatalities from this have rarely been reported. Even rarer is methotrexate (MTX)-induced erosions of clinically normal skin in patients without a history of psoriasis. We report 3 rare presentations of MTX-induced cutaneous erosions, 2 fatalities occurring with MTX-induced psoriatic plaque erosions, and the sixth reported case of MTX-induced erosions with no prior history of psoriasis. Each were elderly patients on proton pump inhibitors with a history of chronic non-steroidal anti-inflammatory drug (NSAID) use. They all presented with acute onset of erosions after a recent change in their MTX dose. Pancytopenia followed in each case. Physicians’ awareness of the sequelae in MTX-induced cutaneous erosions is imperative so MTX can be discontinued and treatment instituted to prevent fatal bone marrow suppression.
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