Cutaneous ulceration with methotrexate.

(1) Low-dose methotrexate, as used to treat rheumatoid arthritis and psoriasis, can cause cutaneous and buccal ulceration. Ulceration of psoriatic plaques is a known adverse effect of methotrexate. Methotrexate can also trigger leg ulcers or make them worse. (2) Cutaneous ulceration has been reported with several other antimitotic and immunosuppressive drugs including hydroxycarbamide (hydroxyurea), tacrolimus, sirolimus, leflunomide, infliximab and etanercept.