Oral ulceration due to methotrexate treatment: A report of 3 cases and literature review

Dervisoglou, Theodoros; Matiakis, Apostolos

doi:10.1515/bjdm-2015-0045

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…The third group includes long-term effects of treatment, such as liver or cardiovascular disease, caused primarily by hyperhomocysteinemia. The most common adverse reactions found include gastrointestinal toxicity [19]. These oral lesions include ulcerative stomatitis, mucositis, and at high doses, can cause EM [18].…”

Section: Discussionmentioning

confidence: 99%

Methotrexate-Induced Oral Erythema Multiforme

SANTOSO,

SHAFURIA,

DEWI

2023

Int J App Pharm

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Objective: To discuss the management of oral erythema multiforme (EM) due to methotrexate (MTX) in gestational trophoblastic tumor patients. Methods: A 28-year-old woman was referred to the Oral Medicine Clinic with complaints of pain throughout the oral cavity accompanied by blackish encrustation on the upper and lower lip for 5 d. She previously underwent the first cycle of chemotherapy using MTX for the treatment of a gestational trophoblastic tumor. Extraoral, multiple diffuse blackish patches on the face and haemorrhagic crusts on the lips with painful erosions. Intraoral, multiple erosive and ulcerative lesions on the labial and buccal mucosa. Results: Management involved topical 0.025% hyaluronic acid mouthwash for erosion and ulceration, compressed 0.9% NaCl for crusted lesions on the lips, and petroleum jelly for the non-crusted lesions on the lips. Complete healing of oral and lip lesions was achieved within 10 d. Conclusion: Pharmacological management should be tailored to each patient with careful consideration of treatment risk or benefit. In our case, the use of non-steroidal anti-inflammatory topical agents was considered successful in treating oral EM.

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Section: Discussionmentioning

confidence: 99%

Methotrexate-Induced Oral Erythema Multiforme

SANTOSO,

SHAFURIA,

DEWI

2023

Int J App Pharm

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“…Деление недельной дозы на 2-3 раза, обычно с интервалом в 12 ч, допустимо, но не рекомендуется. Применение пациентом очередной дозы МТ раньше запланированного времени увеличивает количество пораженных клеток СОПР [23]. Токсичность МТ для СОПР увеличивается при снижении функции почек, приводящем к повышению уровня лекарственного средства в крови из-за сниженного почечного клиренса.…”

Section: клинические варианты нежелательных реакций в полости ртаunclassified

“…Токсичность МТ для СОПР увеличивается при снижении функции почек, приводящем к повышению уровня лекарственного средства в крови из-за сниженного почечного клиренса. Одновременный прием с сульфаниламидами, нестероидными противовоспалительными препаратами, пожилой возраст, индивидуальная восприимчивость, сопутствующие заболевания, употребление алкоголя и наличие сопутствующих инфекционных процессов также повышают вероятность развития НР [23].…”

Section: клинические варианты нежелательных реакций в полости ртаunclassified

“…Поражения полости рта при этом, как правило, полностью регрессируют в течение 2-3 нед. При необходимости назначают дополнительный прием фолиевой кислоты, местную симптоматическую терапию [16,23,27].…”

Section: подходы к профилактике и лечению поражений в полости ртаunclassified

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Adverse Oral Reactions Associated with Low Doses of Methotrexate

Изможерова¹,

Попов²,

Gaisina³

et al. 2020

Bezopasnost' i risk farmakoterapii

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Doctors of various medical specialties often encounter adverse drug reactions in their clinical practice. Methotrexate (MTX) can cause adverse reactions in the oral cavity, primarily erosions and ulcerations. The aim of the study was to analyse scientific literature on the prevalence, pathophysiological mechanisms, risk factors for oral lesions associated with low doses of MTX, their prevention and treatment. It was demonstrated that the most frequent oral adverse reactions associated with low doses of MTX are hard-to-heal painful necrotic and often irregularly shaped lesions of the oral mucosa (including aphthae and ulcers). The spectrum of histopathological changes ranges from nonspecific ulcerations to lichenoid reactions. Treatment of oral lesions induced by low doses of MTX consists in drug withdrawal or dose tapering. Folic acid and local symptomatic therapy can also be used, if necessary. Practitioners should be aware of the potential development of MTX-induced oral lesions, and specific aspects of the drug pharmacokinetics and pharmacodynamics in order to be able to ensure timely detection of adverse reactions and their effective treatment.

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“…Erosive mucositis from MTX has been reported and may herald impending cytopenias, which may progress to fatal bone marrow failure (Demirkan et al, 2017, Knoll et al, 2016). Risk factors include dose escalations or treatment reinitiation, hypoalbuminemia, renal insufficiency, and use of certain drugs that displace MTX from plasma proteins or decrease its excretion, such as nonsteroidal anti-inflammatory drugs, sulfonamides, aspirin, or other antibiotics (Dervisoglou and Matiakis, 2015, Knoll et al, 2016). Folate or folinic acid substitution, as well as alkalinization of the urine, may hasten reversal of MTX-induced erosive mucositis (Dervisoglou and Matiakis, 2015, Knoll et al, 2016).…”

Section: Traditional Chemotherapymentioning

confidence: 99%

Dermatologic conditions in women receiving systemic cancer therapy

Ferreira

Ramseier

Leventhal

2019

International Journal of Women's Dermatology

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As advances in cancer therapies have improved cancer-related survival, novel therapeutics have also introduced a variety of dermatologic toxicities, and an increased number of patients are living with these sequalae. Women with cancer in particular experience a spectrum of dermatologic conditions that affect their skin, hair, nail, and mucosal surfaces. Studies have shown that these toxic effects can significantly affect quality of life and alter a woman’s self-image, cultural identity, femininity, sexuality, and mental health. In severe instances, dermatologic toxicities may even disrupt cancer therapy and can therefore affect overall survival and treatment response. In this article, we review the dermatologic adverse effects from traditional chemotherapy, targeted therapy, immune checkpoint inhibitors, and endocrine therapy that disproportionately affect women. The timely diagnosis and management of these dermatologic conditions is crucial in the multidisciplinary care of women with cancer.

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Oral ulceration due to methotrexate treatment: A report of 3 cases and literature review

Cited by 4 publications

References 16 publications

Methotrexate-Induced Oral Erythema Multiforme

Methotrexate-Induced Oral Erythema Multiforme

Adverse Oral Reactions Associated with Low Doses of Methotrexate

Dermatologic conditions in women receiving systemic cancer therapy

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