The use of methotrexate in dermatology: a review


  • Sarah Shen, BMedSci, MBBS. Tim O’Brien, FACD. Lei Mee Yap, FACD. H. Miles Prince, FRACP. Christopher J McCormack, FACD.

Dr Sarah Shen, St Vincent's Hospital, 41 Victoria Parade, Fitzroy, Vic. 3065, Australia. Email:


Methotrexate is a synthetic folic acid analogue valued for both its anti-proliferative and anti-inflammatory properties. Considered one of the original immune-modifying agents, it is used widely for the treatment of steroid-recalcitrant inflammatory diseases. While there are abundant studies documenting its efficacy in rheumatic diseases, the use of methotrexate for dermatological conditions, with the exception of psoriasis, has yet to be comprehensively explored. This two-part review firstly outlines current data concerning the pharmacology of methotrexate, including its mechanism of action, side-effect profile and recommended therapeutic approach, and, secondly, examines the emerging evidence for methotrexate's efficacy in a wide range of cutaneous disorders.