Methotrexate-induced epidermal necrosis: A case series of 24 patients

Chen, Ting Jui; Chung, Wen Hung; Chen, Chun Bing; Hui, Rosaline Chung‐Yee; Huang, Yu Huei; Lu, Yueh Tsung; Wang, Chang Wei; Wang, Kuo Hsien; Li, Yang; Hung, Shuen Iu

doi:10.1016/j.jaad.2017.02.021

Cited by 36 publications

(21 citation statements)

References 38 publications

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“…Within dermatology, this has occurred almost exclusively in the setting of psoriasis. 2 A potential explanation may be increased cell turnover, making these tissues particularly susceptible to cytocidal effects. 2 There are only 8 reported cases in nonpsoriatic patients with an underlying primary dermatologic disease, either bullous pemphigoid or mycosis fungoides ( Table I ).…”

Section: Discussionmentioning

confidence: 99%

“… 2 A potential explanation may be increased cell turnover, making these tissues particularly susceptible to cytocidal effects. 2 There are only 8 reported cases in nonpsoriatic patients with an underlying primary dermatologic disease, either bullous pemphigoid or mycosis fungoides ( Table I ). 2 , 5 , 6 , 7 , 8 To our knowledge, this is the first reported case of methotrexate-induced cutaneous ulceration and necrosis in atopic dermatitis.…”

Section: Discussionmentioning

confidence: 99%

“…Within dermatology, this phenomenon has occurred almost exclusively in psoriasis. 2 We present a case of methotrexate-induced cutaneous ulceration and necrosis in chronic atopic dermatitis.…”

Section: Introductionmentioning

confidence: 99%

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Methotrexate-induced cutaneous ulceration and necrosis in chronic atopic dermatitis

et al. 2020

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Methotrexate-induced cutaneous ulceration and necrosis in chronic atopic dermatitis

et al. 2020

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“…Some articles enclose pictures that are not very suggestive of SJS/TEN but of an alternative diagnosis, including erythema multiforme, GVHD, and toxic erythema of chemotherapy. For instance, methotrexate-induced epidermal necrosis is a distinct entity that closely mimics SJS/TEN but exhibits distinct clinicopathological features from SJS/TEN [ 88 ]. Many of the reported articles did not obtain skin biopsy for pathology examination and hence, it is difficult to draw to a definitive diagnosis of SJS/TEN.…”

Section: Chemotherapymentioning

confidence: 99%

Anticancer Drugs Induced Severe Adverse Cutaneous Drug Reactions: An Updated Review on the Risks Associated with Anticancer Targeted Therapy or Immunotherapies

Chen

et al. 2018

Journal of Immunology Research

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Cutaneous adverse drug reactions are commonly seen in patients with anticancer drug treatment. Anticancer drugs, including chemotherapy, target therapy, and recent immunotherapy causing skin reactions ranging from mild skin rash to life-threatening severe cutaneous adverse reactions (SCARs), such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrosis (TEN) with increase morbidity and mortality while they are receiving cancer treatments, have been proposed to be a result of direct skin toxicity or drug hypersensitivity reactions (these are proposed mechanism, not definite). Differentiating SCARs from other more commonly seen reactions with a better outcome help prevent discontinuation of therapy and inappropriate use of systemic immunosuppressants for presumable allergic reactions, of which will affect the clinical outcome. In this article, we have reviewed published articles from 1950 to August 2017 for SJS/TEN associated with anticancer drugs, including chemotherapy, targeted therapy, and immunotherapy. We aimed to provide an overview of SJS/TEN associated with anticancer drugs to increase clinician recognition and accelerate future studies on the pathomechanism and managements.

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“…Standard treatments for AOSD include corticosteroids as the first-line, the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and disease-modifying antirheumatic drugs (DMARDS) to manage the clinical symptoms [6,10,11]. Nevertheless, AOSD still lacks effective therapeutics, as its etiology and pathophysiology remain unclear [12].…”

Section: Introductionmentioning

confidence: 99%

Genetic Association and Expression Correlation between Colony-Stimulating Factor 1 Gene Encoding M-CSF and Adult-Onset Still’s Disease

Chen

Hung

Chang

et al. 2020

Journal of Immunology Research

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Adult-onset Still’s disease (AOSD) is a rare and inflammatory disorder characterized by spiking fever, rash, arthritis, and multisystemic involvement. HLA has been shown to be associated with AOSD; however, it could not explain the innate immunity and autoinflammatory characteristics of AOSD. To assess the genetic susceptibility of AOSD, we conducted a genome-wide association study (GWAS) on a cohort of 70 AOSD cases and 688 controls following a replication study of 36 cases and 200 controls and meta-analysis. The plasma concentrations of associated gene product were determined. The GWAS, replication, and combined sample analysis confirmed that SNP rs11102024 on 5′-upstream of CSF1 encoding macrophage colony-stimulating factor (M-CSF) was associated with AOSD (P=1.20×10-8, OR (95% CI): 3.28 (2.25~4.79)). Plasma levels of M-CSF increased in AOSD patients (n=82, median: 9.31 pg/mL), particularly in the cases with activity score≥6 (n=42, 10.94 pg/mL), compared to the healthy donors (n=68, 5.31 pg/mL) (P<0.0001). Patients carrying rs11102024TT genotype had higher M-CSF levels (median: 20.28 pg/mL) than those with AA genotype (6.82 pg/mL) (P<0.0001) or AT genotype (11.61 pg/mL) (P=0.027). Patients with systemic pattern outcome were associated with elevated M-CSF and frequently observed in TT carriers. Our data suggest that genetic variants near CSF1 are associated with AOSD and the rs11102024 T allele links to higher M-CSF levels and systemic outcome. These results provide a promising initiative for the early intervention and therapeutic target of AOSD. Further investigation is needed to have better understandings and the clinical implementation of genetic variants nearby CSF1 in AOSD.

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Methotrexate-induced epidermal necrosis: A case series of 24 patients

Cited by 36 publications

References 38 publications

Methotrexate-induced cutaneous ulceration and necrosis in chronic atopic dermatitis

Methotrexate-induced cutaneous ulceration and necrosis in chronic atopic dermatitis

Anticancer Drugs Induced Severe Adverse Cutaneous Drug Reactions: An Updated Review on the Risks Associated with Anticancer Targeted Therapy or Immunotherapies

Genetic Association and Expression Correlation between Colony-Stimulating Factor 1 Gene Encoding M-CSF and Adult-Onset Still’s Disease

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