Title:Oral Squamous Cell Carcinoma Following Acute Methotrexate Toxicity in
a Psoriasis Patient: A Causal Association or Mere Co-Incidence
Volume: 18
Issue: 4
Author(s): Ritul Choudhary, Ajeet Singh*, Namrata Chhabra and Ashish Kumar Gupta
Affiliation:
- Department of Dermatology, AIIMS Raipur, Chhattisgarh, India
Keywords:
Chronic plaque psoriasis, methotrexate toxicity, squamous cell carcinoma of head and neck, drug related side effects, immunohistochemistry of neoplasms, OSCC.
Abstract:
Background: Methotrexate is an antimetabolite anticancer drug frequently used in the
treatment of extensive chronic plaque psoriasis. Psoriasis patients on treatment with immunosuppressants
have an increased risk of developing malignancies.
Objective: To present a rare case of Oral Squamous Cell Carcinoma (OSCC) in a psoriasis patient
postacute methotrexate toxicity.
Case Report: A 47-year-old female, a known case of chronic plaque psoriasis for which she was on
15 mg/ week methotrexate therapy and accidentally consumed 15 mg for 7 consecutive days. She
was successfully treated for methotrexate toxicity and 45 days later she presented with exophytic
growth on the tongue. Histopathology confirmed the diagnosis of squamous cell carcinoma and the
patient underwent surgical resection.
Conclusion: There could be a causal association between psoriasis and OSCC in the setting of acute
methotrexate toxicity, as in the present case.
