Multiple toxic effects of low-dose methotrexate in a patient treated for psoriasis.

Purpose: A case of toxicity encountered with low-dose methotrexate therapy is discussed.

Summary: A 59-year-old African American woman receiving long-term therapy for psoriasis came to the hospital with painful ulcers, difficulty swallowing, cutaneous lesions, and acute renal failure. Her medical history included type 2 diabetes mellitus, hypertension, coronary artery disease, morbid obesity, and psoriasis.