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April 7, 1969, Vol 208, No. 1 >
ARTICLE | April 7, 1969

Cirrhosis and Methotrexate Treatment of Psoriasis

Robert Auerbach, MD
JAMA. 1969;208(1):155. doi:10.1001/jama.1969.03160010151041.
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ABSTRACT

To the Editor:—  Regarding the article by Coe and Bull, "Cirrhosis Associated With Methotrexate Treatment of Psoriasis" (206:1515, 1968), I would like to make the following points:One hundred milligrams of methotrexate intravenously administered is too large for a first dose (Arch Derm89:550, 1964). Certainly a first dose should be a test dose of no more than 25.0 mg or 0.5 mg/kg, whichever is less. The second two doses of methotrexate were given with a three-day interval; this interval is much closer than the recommended schedule for the treatment of psoriasis.In both this and the other patients the schedule involved five days of treatment and a two-day rest period. This was continued for 11 to 42 months. The rest periods were not long enough. There should be at least four to five days between courses of orally administered therapy. It would be most unusual to have to keep

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AAM 2010;304:1493-1495.
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BMJ 2010;341:c5893-c1494.
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