Topical methotrexate effective in psoriasis treatment: Study

USA: Topical methotrexate (MTX) has been effective in treating psoriasis, says an article published in the Journal of Dermatological Treatment.

The study showed that the quality of evidence for the use of topical methotrexate in psoriasis is good, however, the quality is poor for other dermatologic diseases. This implies that topical MTX with improved delivery methods may be a viable tool against certain localized dermatologic conditions for patients who do not tolerate oral MTX. 

Although systemic methotrexate is an effective therapy for many dermatological disorders, individuals with mild or limited illness should not get it due to the possibility of side effects. It may be possible to prevent the systemic side effects of oral MTX by applying it topically. In order to determine the effectiveness and safety of topical methotrexate in the dermatologic field, Divya Aickara and colleagues undertook this study.

In the end, the study contained 47 papers from various databases such as PubMed, that discussed both new studies on the topical distribution of MTX and the usage of topical MTX in dermatology.

The key findings of this study were as follows:

1. In addition to mycosis fungoides, lymphomatoid papulosis, and oral precancerous lesions, topical MTX has also been used to treat psoriasis.

2. The ideal composition and delivery method are currently being researched for sufficient penetration.

3. Nanotechnology, electroporation, laser-assisted delivery, and iontophoresis are a few of the novel delivery techniques now being researched.

4. These techniques, according to the researchers, should aid in addressing worries about MTX for psoriasis delivery issues, which are a major factor in why prior studies found topical MTX for psoriasis to be mainly unsuccessful.

5. Future topical methotrexate use may become more practical as delivery techniques advance.

6. Compared to oral MTX or topical steroids, topical MTX has fewer side effects.

7. The main therapeutic hurdle continues to be poor patient adherence.

In conclusion, for individuals who cannot take oral MTX, topical MTX with better delivery techniques may be an effective treatment for some localized dermatologic diseases. To support the effectiveness of topical methotrexate, more double-blinded randomized controlled trials are required.

Reference: 

Aickara, D., Bashyam, A. M., Pichardo, R. O., & Feldman, S. R. (2020). Topical methotrexate in dermatology: a review of the literature. In Journal of Dermatological Treatment (Vol. 33, Issue 1, pp. 512–517). Informa UK Limited. https://doi.org/10.1080/09546634.2020.1770170