Most Read Articles
09 Nov 2017
Treatment with fesoterodine shows efficacy in patients with nocturnal urgency secondary to overactive bladder syndrome and low nocturnal bladder capacity with a mismatch between nocturnal urine production and bladder capacity, reports a recent study.
Pearl Toh, 6 days ago
A study finds no evidence that using pharmaceutical aids alone for smoking cessation helps improve the chances of successful quitting despite promising results in previous randomized trials and routine prescription of such drugs to help quit smoking.
Roshini Claire Anthony, 05 Jan 2018

The addition of daratumumab to a bortezomib-melphalan-prednisone (VMP) regimen appears to improve progression-free survival (PFS) over VMP alone in individuals newly diagnosed with multiple myeloma who are ineligible for stem-cell transplantation, according to findings from the phase III ALCYONE* trial.

01 Jan 2012
A phase III, open-label, single-centre study presents the suitability of DTaP-IPV//PRP-T booster following primary vaccination with DTaP-IPV-Hep B-PRP-T vaccine.

What are the distinct features of MTX-induced epidermal necrosis?

14 Aug 2017
Xander was diagnosed with Stevens-Johnson syndrome, a life-threatening skin condition in which cell death causes the skin layers to separate. Photo credit: PA REAL LIFE/ The Sun UK

Methotrexate-induced epidermal necrosis (MEN) presents clinicopathologic features that are different from Stevens‒Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), according to a study.

“Recognition of the early signs and prognostic factors is important, because the rapid institution of leucovorin may be helpful,” researchers said.

A total of 24 patients with MEN and 150 controls were included in this study, which examined the clinicopathology, risk factors and prognostic factors of MEN. The authors analysed the demographics, pathology and plasma concentrations of methotrexate (MTX).

Extensive skin necrosis (mean 33.2 percent total body surface), but no target lesion, was present in patients with MEN. The histopathology exhibited keratinocyte dystrophy. Furthermore, painful skin erosions, oral ulcers and leukopaenia/thrombocytopaenia were early indicators of MEN.

There was 16.7-percent mortality despite administration of leucovorin to majority of the patients (79.2 percent).

Older age (>60 years), chronic kidney disease and high initial dosage of MTX without folic acid supplementation predicted MEN. MTX clearance was delayed by renal insufficiency.

Severe renal disease and leukopaenia were predictors of poor prognosis in MEN, but none of the Score of Toxic Epidermal Necrosis criteria correlated with mortality of MEN.

The major limitation of this study was its small sample size.

According to researchers, physicians should avoid prescribing MTX to high-risk patients and titrate the dosage slowly upward with folic acid supplementation to lower the risk of MEN, which is a rare but life-threatening cutaneous reaction that mimics SJS/TEN.

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Most Read Articles
09 Nov 2017
Treatment with fesoterodine shows efficacy in patients with nocturnal urgency secondary to overactive bladder syndrome and low nocturnal bladder capacity with a mismatch between nocturnal urine production and bladder capacity, reports a recent study.
Pearl Toh, 6 days ago
A study finds no evidence that using pharmaceutical aids alone for smoking cessation helps improve the chances of successful quitting despite promising results in previous randomized trials and routine prescription of such drugs to help quit smoking.
Roshini Claire Anthony, 05 Jan 2018

The addition of daratumumab to a bortezomib-melphalan-prednisone (VMP) regimen appears to improve progression-free survival (PFS) over VMP alone in individuals newly diagnosed with multiple myeloma who are ineligible for stem-cell transplantation, according to findings from the phase III ALCYONE* trial.

01 Jan 2012
A phase III, open-label, single-centre study presents the suitability of DTaP-IPV//PRP-T booster following primary vaccination with DTaP-IPV-Hep B-PRP-T vaccine.