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Oral Ulceration Due to Methotrexate Treatment: A Report of 3 Cases and Literature Review

Balkan Journal of Dental MedicineFebruary 17, 2016October 11, 2022

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Theodoros Dervisoglou1 / Apostolos Matiakis2

1DMD, Private Dentist
2Aristotle University of Thessaloniki, School of Dentistry, Dept. of Oral Medicine and Pathology, Greece

Summary

Methotrexate (MTX) is an antimetabolite which interferes with DNA synthesis. It is used for the treatment of many diseases, such as psoriasis, rheumatoid arthritis and various neoplastic diseases. It may cause, among various adverse reactions, oral ulceration and oral mucositis. 3 cases of methotrexate related oral ulcers are reported along with a brief review of the relevant literature.

Keywords: Oral Ulceration; Methotrexate; Rheumatoid Arthritis; Psoriatic Arthritis

References

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  2. Lee JH, Hong KS, Seo KJ, Lee D, Sung SH. A Case of Cutaneous Side Effect of Methotrexate Mimicking Behçet’s Disease. Ann Dermatol, 2011; 23(3):412-414. [PubMed] [Crossref]
  3. Kalantzis A, Marshman Z, Falconer TD, Morgan RP, Odell WE. Oral effects of low-dose methotrexate treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2005; 100:52-62. [Crossref]
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  7. Pedrazas SHC, de Azevedo LNM, Torres RS. Oral events related to low-dose methotrexate in rheumatoid arthritis patients. Braz Oral Res, 2010; 24(3):368-373.
  8. Borchers TA, Keen LC, Cheema SG, Gershwin EM. The Use of Methotrexate in Rheumatoid Arthritis. Seminars in Arthritis and Rheumatism, 2004; 34(1, August):465-483.
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  11. Ding C-Z, Yao Y, Feng X-B, Fang Y, Zhao C, Wang Y. Clinical Analysis of Chinese Patients with Rheumatoid Arthritis Treated with Leflunomide and Methotrexate Combined with Different Dosages of Glucocorticoid. Curr Ther Res Clin Exp, 2012; 73:123-133. [Web of Science]
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  13. Epstein BJ, Thariat J, Bensadoun R-J, Barasch A, Murphy AB, Kolnick L, Popplewell L, Maghami E. Oral Complications of Cancer and Cancer Therapy From Cancer Treatment to Survivorship. CA Cancer J Clin, 2012; 62:400-422. [PubMed] [Crossref]
  14. Sadasivam N, Johnson JR, Owen GR. Resolution of methotrexate-induced Epstein-Barr virus-associated mucocutaneous ulcer. Br J Haematol, 2014; 165:584. [Web of Science]
  15. Naidu A, Kessler PH, Pavelka AM. Epstein-Barr Virus-Positive Oral Ulceration Simulating Hodgkin Lymphoma in a Patient Treated with Methotrexate: Case Report and Review of the Literature. J Oral Maxillofac Surg, 2014; 72:724-729. [Web of Science]
  16. Attard AA, Praveen P, Dunn JSP, James JG. Epstein-Barr virus-positive mucocutaneous ulcer of the oral cavity: the importance of having a detailed clinical history to reach a correct diagnosis. Oral Surg Oral Med Oral Pathol Oral Radiol, 2012; 114:e37-e39. [Web of Science]
  17. Pastor-Nieto MA, Kilmurray LG, López-Chumillas A, O’Valle F, Garcia-del Moral R, Puig AM, Bautista P. Methotrexate-Associated Lymphoproliferative Disorder Presenting as Oral Ulcers in a Patient with Rheumatoid Arthritis. Actas Dermosifiliogr, 2009; 100:142-146.
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Citation Information: Balkan Journal of Dental Medicine. Volume 19, Issue 2, Pages 116–120, ISSN (Online) 2335-0245, DOI: https://doi.org/10.1515/bjdm-2015-0045, July 2015

A. Matiakis, adverse effects, chemotherapy, methotrexate, oral ulceration, T. Dervisoglou, ulcerative stomatitis

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