Methotrexate in dermatology: from theory to practice
Methotrexate has established itself as a highly effective treatment for psoriasis since 1953. The effectiveness of methotrexate is due to its cytotoxic and anti-inflammatory effects. According to the draft clinical guidelines of the Russian Society of Dermatovenereologists and Cosmetologists, the use of methotrexate is justified in many skin diseases. A long history and accumulated practical experience of application do not raise doubts about the effectiveness of methotrexate due to its unique pharmacological properties, namely, antiinflammatory, immunomodulatory and cumulative effects, which allow the drug to occupy a leading position in the treatment of many skin diseases. The article describes in detail the metabolism of methotrexate and its pharmacodynamics. According to a review of modern data from the world literature, the authors presented recommendations for treatment with methotrexate, its use in children, monitoring during treatment, and also drew attention to the indications in special situations (infections, vaccinations, contraception, etc.).