High-dose methotrexate-induced epidermal necrosis in two pediatric patients

Methotrexate-induced epidermal necrosis (MEN) is an uncommon but potentially fatal complication. We present two pediatric oncology patients, a 5-year-old girl and a 3-year-old boy, who developed MEN from high-dose methotrexate therapy for pre-B-cell acute lymphocytic leukemia. Following administrati...

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Bibliographic Details
Published in:Pediatric dermatology 2021-05, Vol.38 (3), p.659-663
Main Authors: Ravi, Manisha, Ridpath, Alyson, Audino, Anthony N, Guinipero, Terri, Chung, Catherine, Fernandez Faith, Esteban
Format: Article
Language:English
Subjects:
Case reports
Chemotherapy
Corticosteroids
Cytotoxicity
Dermatology
Folinic acid
Gangrene
Leukemia
Lymphatic leukemia
Methotrexate
Necrosis
Pediatrics
Side effects
Skin diseases
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Summary:Methotrexate-induced epidermal necrosis (MEN) is an uncommon but potentially fatal complication. We present two pediatric oncology patients, a 5-year-old girl and a 3-year-old boy, who developed MEN from high-dose methotrexate therapy for pre-B-cell acute lymphocytic leukemia. Following administration of systemic methotrexate, the patients developed erythematous lesions with subsequent skin erosions. Pre-medication with systemic corticosteroids and administration of folinic acid rescue following the methotrexate infusion allowed both patients to resume their chemotherapy regimen with methotrexate.
ISSN:0736-8046
1525-1470
DOI:10.1111/pde.14591