Methotrexate (MTX) has been one of the most used anti-inflammatory, antimetabolite, and steroid-sparing drugs in dermatology, it was originally developed as an antineoplastic drug for leukemia which was later introduced as a therapeutic option for psoriasis, rheumatoid arthritis, and, recently, for inflammatory skin diseases. MTX is the drug of choice for the systemic treatment of psoriasis, being an effective, safe, and low-cost option. The use of MTX has extended to other inflammatory diseases such as urticaria, atopic dermatitis, pemphigus vulgaris, bullous pemphigoid, and recently, intralesional therapy for cutaneous tumors. Despite the wide range of potential indications, is still continues to be scarce, and mainly derived from case series and reports and prospective, randomized double-blinded studies are lacking. Herein, we will review the main uses of MTX for skin diseases and the evidence regarding its efficacy and safety.
El linfoma de células T/NK es poco frecuente. Las lesiones cutáneas presentan una gran variabilidad clínica al momento de su presentación, desde neoformaciones tipo placa hasta nódulos o úlceras. Presentamos el caso de una mujer de 46 años que presentó perforación de paladar y nódulos y úlceras no dolorosas en el tronco y las extremidades inferiores. Se realizó abordaje diagnóstico, a descartar micosis profunda, y se realizó biopsia de piel con inmunhistoquímica que confirmó un linfoma de células T/NK extranodal de tipo nasal. Se inició tratamiento por parte de hematología con quimioterapia, pero la sobrevida fue de 4 semanas.
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