Shery Mounir William Labib
Skin Klinic, Egypt
Title: Intra-lesional methotrexate in dermatology with highlight on intra-lesional Methotrexate in treatment of hypertrophic scars and keloids
Biography
Biography: Shery Mounir William Labib
Abstract
Methotrexate is an immunosuppressive agent that acts as a folic acid analog which competitively inhibits dihydrofolate reductase enzyme. Methotrexate comes after Prednisolone as one of the most commonly prescribed systemic drugs in dermatology. Methotrexate as an intra-lesional drug was used in treatment of skin tumors as cutaneous squamous cell carcinoma and keratoacanthoma with satisfactory results. Also, several studies used intra-lesional methotrexate (IL-MTX) in treatment of hypertrophic scars/keloids either alone or as an adjuvant to surgery. In addition nail psoriasis was successfully treated with IL-MTX. Same as systemic MTX intake, pre-treatment investigations must be done (complete blood count, liver and kidney function tests and pregnancy test) to exclude any hematological abnormalities, renal insufficiency and risks of hepatotoxicity. For hypertrophic scars and keloids, IL-MTX not only improves thickness and flexibility of scar tissue but also decrease vascularity which results in better functional, aesthetic and psychological impact on the patient. Using IL-MTX is a good treatment modality in treating various skin tumors. It is very promising in hypertrophic scars and keloids. However, more studies are needed to standardize its use.