A clinical evaluation is presented of 204 severe psoriatic patients treated with methotrexate, 25 mg (ten tablets) orally at weekly intervals. Preliminary evaluation of hepatic and renal function is mandatory. The mean age of patients was 44 years; mean duration of psoriasis before methotrexate therapy was 10 years; and the percentage of total body coverage before methotrexate therapy was 67.2%, and after methotrexate therapy was 5.2%. Sixty-one percent of patients (118 patients) had complete clearing of psoriasis while taking methotrexate. The mean length of the follow-up studies is 16 months (range: 2 to 50 months).
Subjective adverse effects of weekly oral doses of methotrexate were: nausea 31%, fatigue 7%, mouth ulcers 6%, headache 5%, hair loss 6%, vomiting 6%, and photosensitivity 5%.
Methotrexate administration in a weekly oral dosage is an effective method of therapy for selected cases of psoriasis vulgaris.