Methotrexate-induced toxic epidermal necrolysis-like skin toxicity.

摘要

We report a 75-year-old male patient suffering from anky-losing spondylitis without pre-existing skin disease, who developed severe methotrexate-(MTX) toxicity clinically as a toxic epidermal necrolysis-(TEN) like skin disease and a toxic myelosuppression. The transition of MTX-induced skin toxicity from acral localized to generalized blisters could be observed, confirming a clinical spectrum of MTX-induced TEN-like skin disease, which clearly differs from erythema multiforme and Stevens-Johnson syndrome. His past medical history included chronic renal failure due to excessive usage of analgesics with a creatinine level of 2.32 mg/dL and nephrectomy due to renal cell carcinoma. Because of worsening of ankylosing spondylitis, MTX treatment was initiated at a dosage of 15 mg intravenously.