Ali Raza Syed, Shahbaz Aman, Muhammad Nadeem, Atif Hasnain Kazmi.
The efficacy and safety of oral methotrexate in chronic eczema.
J Pak Assoc Derma Jan ;19(4):220-4.

Background: Eczema is an extremely common skin problem in our society. Sometimes, chronic eczema becomes resistant to the conventional therapies. Hence, there is a need for an efficacious and safe treatment of patients with recalcitrant, chronic eczema. Objectives: To assess the efficacy and safety of low dose methotrexate (MTX) in chronic eczema. Patients and methods: The study was carried out in the Dermatology Department, Unit-I, Mayo Hospital, Lahore, for one year duration with sixty patients of chronic eczema, using purposive nonprobability sampling technique. Severity of eczema was assessed using Eczema Area and Severity Index (EASI). A reduction of 50% or more in EASI score, after three months of therapy, was considered as effective treatment. Patients in the study group were administered 0.1 mg/ kg body weight of MTX once weekly for three months. Patients of control group were given placebo in the form of folic acid 5 mg tablets once daily for three months. The safety of MTX was judged by clinical and laboratory evaluation of patients on weekly follow-up. Results: All the study group patients had a reduction of 50% or more in EASI score whereas none in the control group had similar reduction. The clinical & laboratory evaluation of the patients on MTX showed no abnormality, signifying methotrexate’s safety in the dose used. Conclusions Methotrexate proved to be an efficacious and safe modality of treatment in patients of chronic eczema.

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