Omoregie F O, Ukpebor M, Saheeb B D
Department of Oral and Maxillofacial Surgery, University of Benin Teaching Hospital, Benin City, Nigeria.
West Afr J Med. 2011 Sep-Oct;30(5):377-9.
Mucosal affectation may be a direct cytotoxic or cytostatic effect of methotrexate.
To highlight the diagnostic procedure and treatment intervention erythema multiforme complicating methotrexate-induced allergic stomatitis.
The patient was a 60-year-old man suffering from stomatitis that rapidly developed into erythema multiforme. The patient had been prescribed methotrexate to treat rheumatoid arthritis. The patient presented with painful ulceration of the vermillion border of the upper and lower lips covered with necrotic tissues. We made a tentative diagnosis of methotrexate induced allergic stomatitis. On the patient's second visit to the clinic, the lesion had developed into crusted and haemorrhagic ulceration with erythematous patches on the lips. The patient was now complaining of weakness, fever and occasional seizure attack. Examination of the upper and lower extremities revealed bilateral bullous eruptions. The definitive diagnosis was that of erythema multiforme complicating methotrexate induced allergic stomatitis. withdrawal of the methotrexate yielded positive result with complete resolution of the lesions after 12 days of drug withdrawal.
Early diagnosis of adverse drug reactions is essential for effective treatment, to avoid untoward systemic complications.
黏膜受累可能是甲氨蝶呤的直接细胞毒性或细胞抑制作用。
强调多形红斑并发甲氨蝶呤诱导的过敏性口炎的诊断程序和治疗干预。
患者为一名60岁男性，患有口炎，迅速发展为多形红斑。该患者曾被处方使用甲氨蝶呤治疗类风湿性关节炎。患者表现为上下唇朱红色边缘疼痛性溃疡，覆盖有坏死组织。我们初步诊断为甲氨蝶呤诱导的过敏性口炎。患者第二次就诊时，病变已发展为结痂和出血性溃疡，嘴唇上有红斑。患者现主诉虚弱、发热和偶尔发作的癫痫。检查上下肢发现双侧大疱性皮疹。最终诊断为多形红斑并发甲氨蝶呤诱导的过敏性口炎。停用甲氨蝶呤产生了积极效果，停药12天后病变完全消退。
药物不良反应的早期诊断对于有效治疗至关重要，以避免不良的全身并发症。
