A practical approach to using methotrexate

Methotrexate is an antimetabolite that was first introduced as an anticancer drug. Due to its anti-inflammatory properties, it is now used – in much lower doses – for the treatment of joint, bowel and skin conditions. In dermatology, low-dose methotrexate is most commonly used to treat psoriasis that has not responded to topical treatments or phototherapy. It is also useful as a steroid sparing agent in bullous pemphigoid, pemphigus, sarcoidosis, dermatomyositis and the vasculitides. Recently, it has been used in morphoea and in mycosis fungoides.