Background: According to Food and Drug Administration (FDA)-approved prescribing information, combination therapy with acitretin and methotrexate (MTX) is contraindicated. This is based on company data suggesting increased hepatotoxicity in patients who received concomitant methotrexate and etretinate, the prodrug of acitretin.
Methods: We reviewed the clinical data of 18 patients with psoriasis who received methotrexate and acitretin concurrently.