Psoriasis-Liver-Methotrexate Interactions

doi:10.1001/archderm.1973.01620220008002

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Vol. 108 No. 1, July 1973

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COOPERATIVE STUDY

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Psoriasis-Liver-Methotrexate Interactions

G. Weinstein, MD; H. Roenigk, MD; H. Maibach, MD; J. Cosmides, MD; K. Halprin, MD; M. Millard, MD; J. Almeyda, MD; R. Auerbach, MD; H. Tobias, MD; W. Bergfeld, MD; D. Clyde, PhD; M. Dahl, MD; P. Frost, MD; E. Schiff, MD; R. Krueger, MD; J. Tindall, MD; J. Lee, MD; A. Lundquist, MD; F. Schaffner, MD; P. Scheuer, MD; H. Zachariae, MD

Arch Dermatol. 1973;108(1):36-42.

Abstract

An international cooperative study was organized to evaluatewhether the treatment of severe psoriasis with methotrexatesignificantly affects the liver of these patients. From a studypopulation of 550 patients, 742 liver biopsy specimens togetherwith pertinent clinical and laboratory data were evaluated asa function of methotrexate usage.

Factors found to be significantly associated with histologicliver damage include: increased alcohol intake, the daily orallyadministered methotrexate dosage schedule, obesity, and diabetes.The evidence implicating increasing cumulative methotrexatedosage as a cause of hepatic fibrosis is not clear. Of 247 patientswith biopsyproven fibrosis or cirrhosis, 88 patients had norecorded abnormalities in history, physical examination, orlaboratory test results which casts serious doubt on the reliabilityof detecting fibrosis or cirrhosis without a liver biopsy.

Author Affiliations

University of Miami School of Medicine, Miami, Fla; Cleveland Clinic, Cleveland; University of California, San Francisco; University of Miami School of Medicine, Miami, Fla; London Hospital, London; New York University, New York; Cleveland Clinic, Cleveland; Clyde Computing Service, Miami, Fla; the Royal Victoria Infirmary, Newcastle-upon-Tyne, England; University of Miami School of Medicine, Miami, Fla; Duke University, Durham, NC; University of California, San Francisco; University of Lund, Lund, Sweden; Mount Sinai School of Medicine, New York; Royal Free Hospital, London; Marselisborg Hospital, Copenhagen

Footnotes

Accepted for publication March 14, 1973.

Reprint requests to Department of Dermatology, University ofMiami School of Medicine, PO Box 875, Miami, FL 33152 (Dr. Weinstein).

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