Background: Pathologists are often faced with the dilemma of whether to recommend continuation of methotrexate therapy for psoriasis within the context of an existing pro-fibrogenic risk factor, in this instance, patients with genetic hemochromatosis. Case presentations: We describe our experience with two male psoriatic patients (A and B) on long term methotrexate therapy (cumulative dose A=1.56 gms and B=7.88 gms) with hetero- (A) and homozygous (B) genetic hemochromatosis. These patients liver function were monitored with routine biochemical profiling; apart from mild perivenular fibrosis in one patient (B), significant liver fibrosis was not identified in either patient with multiple interval percutaneous liver biopsies; in the latter instance this patient (B) had an additional risk factor of partiality to alcohol. Conclusion: We conclude that methotrexate therapy is relatively safe in patients with genetic hemochromatosis, with no other risk factor, but caution that the risk of fibrosis be monitored, preferably by non-invasive techniques, or by liver biopsy. © 2005 Mathew et al., licensee Central Ltd.
CITATION STYLE
Mathew, J., Leong, M. Y., Morley, N., & Burt, A. D. (2005). A liver fibrosis cocktail? Psoriasis, methotrexate and genetic hemochromatosis. BMC Dermatology, 5. https://doi.org/10.1186/1471-5945-5-12
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