Methotrexate induced liver disease in psoriasis

A review of the effects of folic acid antagonists in psoriasis has now been completed. All nineteen patients have had such therapy for at least i year and some for up to 10 years. Seventeen of these patients have had recent liver biopsies and another two were studied at post mortem. The biopsy find‐ings were analysed according to mode(s) of therapy. All three patients with cirrhosis and three of four with fibrosis had received significant amounts of oral methotrexate. Eight patients had received methotrexate only by parenteral injection and only one biopsy showed mild fibrosis. A possible ancillary factor is the severity of psoriasis.