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IMPORTANCE A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide.OBJECTIVE To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics.DESIGN, SETTING, AND PARTICIPANTS Between September 2020 and March 2021, a survey study with a modified eDelphi procedure that was developed and distributed by the Amsterdam University Medical Center and completed by 180 participants worldwide (55 [30.6%] resided in non-Western countries) was conducted in 3 rounds. The proposals on which no consensus was reached were discussed in a conference meeting (June 2021). Participants voted on 21 proposals with a 9-point scale (1-3 disagree, 4-6 neither agree nor disagree, 7-9 agree) and were recruited through the Skin Inflammation and Psoriasis International Network and European Academy of Dermatology and Venereology in June 2020. Apart from being a dermatologist/dermatology resident, there were no specific criteria for participation in the survey. The participants worked mainly at a university hospital (97 [53.9%]) and were experienced in treating patients with psoriasis with methotrexate (163 [91.6%] had more than 10 years of experience). MAIN OUTCOMES AND MEASURESIn a survey with eDelphi procedure, we tried to reach consensus on 21 proposals. Consensus was defined as less than 15% voting disagree (1-3). For the consensus meeting, consensus was defined as less than 30% voting disagree. RESULTSOf 251 participants, 180 (71.7%) completed all 3 survey rounds, and 58 participants (23.1%) joined the conference meeting. Consensus was achieved on 11 proposals in round 1, 3 proposals in round 2, and 2 proposals in round 3. In the consensus meeting, consensus was achieved on 4 proposals. More research is needed, especially for the proposals on folic acid and the dosing of methotrexate for treating subpopulations such as children and vulnerable patients. CONCLUSIONS AND RELEVANCEIn this eDelphi consensus study, consensus was reached on 20 of 21 proposals involving methotrexate dosing in patients with psoriasis. This consensus may potentially be used to harmonize the treatment with methotrexate in patients with psoriasis.

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Background: Cosmetic procedures are on the rise and practiced by all age groups, especially by teenagers. These procedures enhance the individual appearance and confidence levels, but they are not without side effects. Aims and Objectives: The aim of this study was to evaluate the side effects occurring after various parlor procedures such as facials, threading, waxing, and laser hair reduction. Setting and Design: A prospective study for 12 months in a tertiary hospital. Materials and Methods: Patients attending the department of dermatology at a tertiary care hospital for 12 months (July 2018–June 2019) were evaluated for any skin lesions, developed after one of the above parlor procedures. Detailed history, clinical examination, and correlation with the parlor procedure were noted. Results: A total of 102 patients were found to have dermatoses after various parlor procedures during the 1-year study period (81 F and 21 M). Acneiform eruptions 26 (25.4%), followed by post-waxing folliculitis 17(16.7%), and hyperpigmentation of face 15 (14.7%) were the most common dermatoses. Molluscum contagiosum, verrucae plana, and tinea faciei were observed in 11, 6, and 3 patients, respectively. Conclusion: Side effects are not uncommon after parlor procedures. Awareness of these is necessary and educating the patients is extremely important to avoid these unwanted complications.