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The stimulus to develop guidelines for the use of methotrexate in psoriasis in the summer of 1971 stemmed from the inability to determine the direction the Federal Drug Administration would take regarding the use of this drug. Methotrexate had been in common use in this disease for several years and was generally felt to be a relatively safe medication, documented by many reports in the literature, until isolated reports of hepatic cirrhosis and liver failure appeared. Medico-legal situations soon developed with the potential that large sums might be awarded. It became clear that the situation was getting out of hand at a rapidly accelerating pace. Thus, it was felt that a set of guidelines, possibly approved by an official body of dermatologists, would provide a formal basis for the use of this drug in dermatologic practice. Thus, in July 1971, the Psoriasis Task Force of the National Program of Dermatology
Roenigk HH, Maibach HI, Weinstein GD. Use of Methotrexate in Psoriasis. Arch Dermatol. 1972;105(3):363-365. doi:10.1001/archderm.1972.01620060005001