The Anti-Psoriatic Efficacy and Safety Profile of Topical and Intralesional Methotrexate: A Literature Review
Issued Date
2022-01-01
Resource Type
eISSN
11787015
Scopus ID
2-s2.0-85140486810
Journal Title
Clinical, Cosmetic and Investigational Dermatology
Volume
15
Start Page
2253
End Page
2274
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical, Cosmetic and Investigational Dermatology Vol.15 (2022) , 2253-2274
Suggested Citation
Chaiyabutr C. The Anti-Psoriatic Efficacy and Safety Profile of Topical and Intralesional Methotrexate: A Literature Review. Clinical, Cosmetic and Investigational Dermatology Vol.15 (2022) , 2253-2274. 2274. doi:10.2147/CCID.S380218 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86266
Title
The Anti-Psoriatic Efficacy and Safety Profile of Topical and Intralesional Methotrexate: A Literature Review
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Methotrexate (MTX) has long been considered the first-line oral systemic pharmacotherapy for psoriasis. The drug has several well-known systemic side effects, such as bone marrow suppression and hepatotoxicity. To avoid them, the use of topical or intralesional administrations of MTX has become an interesting option. With the advent of novel drug delivery systems, especially nanocarriers, the usage of a high-efficacy and safe topical MTX for psoriasis has nearly been attained. This review examined the development, anti-psoriatic efficacy and adverse effects of topical forms of MTX (plain MTX; MTX with chemical enhancer; MTX using nanotechnology; MTX with protein transduction domains; MTX with liquid crystalline systems; and MTX with physical enhancer/laser) and intralesional MTX in psoriasis patients and psoriasis-induced animals. The efficacy of topical MTX varied with the drug delivery technology employed. Nevertheless, the overall safety profile of the topical forms was favourable. A 25 mg/mL MTX solution injected intralesionally at the nail matrix worked well for nail psoriasis recalcitrant to topical treatment. To improve the standard of care for patients with psoriasis, randomized controlled trials that establish the most effective MTX-delivery system are needed.