Innovative approach on monitoring methotrexate induced hepatotoxicity in psoriasis patients – A case report

Introduction: Methotrexate is often used as the first line of systemic treatment in patients with moderate to severe psoriasis and psoriatic arthritis.

Case report: We present the case of a 44-year-old male patient with moderate plaque psoriasis who was treated with Methotrexate and diagnosed with mild hepatic steatosis during the first month of treatment. Using FIB-4 (Fibrosis Index Based on 4 factors) as a noninvasive method for assessing the risk of liver fibrosis, the patient was able to take Methotrexate safely, with close monitoring of liver function.

Conclusions: FIB-4 can be used to assess the risk of liver fibrosis in psoriasis patients treated with Methotrexate to ensure better adherence to the treatment.