Fourteen patients with recalcitrant psoriasis refractory to conventional therapy (including methotrexate [MTX]) have been evaluated for their response to minute divided oral doses of methotrexate. Patients received between 0.5 and 0.6 mg of methotrexate four to six times daily for a ten-day period. The clinical responses to this regimen were gratifying in that 67% obtained excellent results, 10% obtained good results, and 17%, moderate results. Psoriatic arthritis and exfoliative erythroderma both cleared rapidly. In addition, clinical toxicity was mild in four patients and consisted principally of mild stomatitis and sore throat which disappeared with drug stoppage. Laboratory evidence of toxicity was limited to transient rises in serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase levels in two patients and slight elevation of serum alkaline phosphatase in one patient. Remissions were sustained for two months to eight months or more.
Spiro JM, Demis DJ. Treatment of Psoriasis With Minute Divided Oral Doses of Methotrexate. Arch Dermatol. 1969;99(4):459–464. doi:10.1001/archderm.1969.01610220087015
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