Abstract
When phototherapy alone or methotrexate alone results in inadequate response for a patient with psoriasis or atopic dermatitis, the two therapies can be combined safely and effectively. Extremely rarely, methotrexate can induce an acute or delayed phototoxic reaction following phototherapy. In order to minimize this risk, there should be maximum amount of time between the dose of methotrexate and the next phototherapy session. Just like with other photosensitizing medications, minimizing blood levels of the medication at the time of phototherapy results in the lowest risk of phototoxicity.
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References
Asawanonda P, Nateetongrungsak Y. Methotrexate plus narrowband UVB phototherapy versus narrowband UVB phototherapy alone in the treatment of plaque-type psoriasis: a randomized, placebo-controlled study. J Am Acad Dermatol. 2006;54:1013–8.
Paul BS, Momtaz L, Stern RS, Arndt KA, Parrish JA. Combined methotrexate-ultraviolet B therapy in the treatment of psoriasis. J Am Acad Dermatol. 1982;7:758–62.
Morison WL, Momtaz K, Parrish JA, Fitzpatrick TB. Combined methotrexate-PUVA therapy in the treatment of psoriasis. J Am Acad Dermatol. 1982;6:46–51.
Fernández RJ, Jordá PA, Fernández-Navarro JM, Sales AA, Ramiro AN, Miralles AV. Photoxicity reaction due to methotrexate. An Pediatr (Barc). 2012;76(3):179–80.
Okamoto H, Fukuda A, Mizuno K, Matsuyoshi N, Fujii K, Imamura S. Reactivation of phototoxicity test for psoralens plus ultraviolet A by low-dose methotrexate. Photodermatol Photoimmunol Photomed. 1994;10(3):134–6.
Westwick TJ, Sherertz EF, McCarley D, Flowers FP. Delayed reactivation of sunburn by methotrexate: sparing of chronically sun-exposed skin. Cutis. 1987;39(1):49–51.
Kalb RE, Strober B, Weinstein G, Lebwohl M. Methotrexate and psoriasis: 2009 National Psoriasis Foundation Consensus Conference. J Am Acad Dermatol. 2009;60(5):824–37.
Stern RS, Kleinerman RA, Parrish JA, Fitzpatrick TB, Bleich HL. Phototoxic reactions to photoactive drugs in patients treated with PUVA. Arch Dermatol. 1980;116(11):1269–71.
Saxena AK, Dhungel S, Bhattacharya S, Jha CB, Srivastava AK. Effect of chronic low dose methotrexate on cellular proliferation during spermatogenesis in rats. Arch Androl. 2004;50:33–5.
Green DM, Zevon MA, Lowrie G, Seigelstein N, Hall B. Congenital abnormalities in children of patients who received chemotherapy for cancer in childhood and adolescence. N Engl J Med. 1991;325:141–6.
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Koo, J., Nakamura, M. (2017). Combining Phototherapy with Methotrexate. In: Clinical Cases in Phototherapy. Clinical Cases in Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-51599-1_18
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DOI: https://doi.org/10.1007/978-3-319-51599-1_18
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