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Methotrexate and Psoriasis

Thomas A. Hayes, MD
JAMA. 1970;213(5):874. doi:10.1001/jama.1970.03170310152060.
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To the Editor.—  The editorial (212: 314, 1970) on psoriasis, methotrexate, and cirrhosis presents a cogent and balanced approach to the treatment of a patient with a long-term and recurrent problem. We feel that one statement ("... indications are expanding to include milder degrees of involvement where only cosmetic inconvenience exists") may be open to misinterpretation.The Food and Drug Administration (FDA) approved the use of methotrexate in 1959 for treatment of certain neoplastic disease. Recently a warning statement concerning the risk of hepatoxicity during chronic administration was added to the package insert.We limit the term "indications" to uses approved by FDA. An application which had been submitted to the FDA providing for the use of methotrexate in patients with severe recalcitrant psoriasis was withdrawn one year ago; we are now awaiting the completion and submission of pharmacologic studies establishing the safety of chronic use and clinical studies developing dosage


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