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October 1983

Concurrent Methotrexate and Etretinate Therapy for Psoriasis

Author Affiliations

Private Bag Wellington Hospital Riddiford Street Newtown, Wellington New Zealand

Arch Dermatol. 1983;119(10):793. doi:10.1001/archderm.1983.01650340003007

To the Editor.—  I read with interest the report by Vanderveen et al in the September Archives (1982;118:660-662) concerning the use of methotrexate and etretinate as concurrent therapies in severe psoriasis. I would like to add an almost identical case to the record. The possibility of drug interactions makes it important to document safe and successful treatment regimens.I saw a 46-year-old man who had suffered from severe erythrodermic and exfoliative psoriasis for seven years. In the previous two years the patient had spent half of his life as a hospital inpatient for treatment of his disease. The basic therapy had been coal tar ointment applied topically and weekly intravenous (IV) methotrexate. During 1982 episodes of pustulation began on the limbs, associated with fever and leukocytosis. In September he was extremely ill with staphylococcal bacteremia and it was decided to add etretinate to his therapy. Having had no previous experience

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