Evidence map›Paper›PMID 40893823›Full record

ArticleClinical, cosmetic and investigational dermatology2025

Methotrexate-Induced Leukocytoclastic Vasculitis: A Case Report and Literature Review.

Yanisa Ratanapokasatit, Natthachat Jurairattanaporn

Abstract readCase Reports
In one paragraph

Article in Clinical, cosmetic and investigational dermatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Yanisa RatanapokasatitDivision of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.ORCID 0000-0001-8303-3323
Natthachat JurairattanapornDivision of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.ORCID 0000-0002-5190-5796

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Methotrexate (MTX) is widely utilized for the management of autoimmune diseases and neoplasms. It may cause several adverse effects, including myelosuppression, hepatitis, and mucositis, and in rare cases, can result in cutaneous vasculitis. We present a case involving a 60-year-old female patient receiving 5 milligrams (mg) of MTX weekly for the treatment of systemic lupus erythematosus (SLE). Her underlying condition was end-stage renal disease (ESRD), requiring hemodialysis (HD). Ten weeks after MTX treatment, she developed oral ulcers, pancytopenia, and hepatitis, followed by multiple non-blanchable erythematous papules, along with a few vesicles and pustules on the neck, trunk and arms. Laboratory results indicated elevated serum MTX levels, and skin biopsy demonstrated dense superficial perivascular and interstitial lymphocytic, eosinophilic, and neutrophilic infiltration, along with nuclear debris and extravasated erythrocytes, indicative of early leukocytoclastic vasculitis (LCV). Direct immunofluorescence (DIF) identified C3 deposits at the dermo-epidermal junction and superficial blood vessels, indicating possible immune complex-mediated vascular disease. The patient was diagnosed with MTX toxicity and histologically confirmed LCV secondary to MTX. MTX toxicity was effectively treated with intravenous folinic acid and cessation of MTX, alongside prescriptions of oral prednisolone and emollients for LCV management. Serum MTX levels became undetectable after a five-day treatment regimen. Skin lesion resolution occurred within one week. Additionally, a review of existing literatures on MTX-induced LCV was conducted.

Indexed as

cutaneous small vessel vasculitismethotrexatetoxicitytype III hypersensitivity reaction

Identifiers

PMID40893823
PMCPMC12393089

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.