Skin reaction at site of intrathecal methotrexate
Journal name: World Journal of Pharmaceutical Research
Original article title: Skin reaction at site of intrathecal methotrexate
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Ahmed Mjali, Bushra Najeh Hasan Al Baroodi, Haider Hasan Jaleel Al –Shammari, Rasha K. Muhsin and Nareen Tawfeeq Abbas
World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: Skin reaction at site of intrathecal methotrexate
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr201910-15723
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Summary of article contents:
Introduction
Intrathecal methotrexate is commonly used as an essential chemotherapy treatment for acute lymphoblastic leukemia (ALL), particularly for prophylaxis against central nervous system (CNS) involvement. While the effectiveness of this treatment is well-documented, complications associated with intrathecal administration are of significant concern. Dermatological complications such as skin burns resulting from intrathecal methotrexate administration are extremely rare but can have serious repercussions.
Dermatological Complications of Methotrexate Treatment
Skin reactions are one of the known side effects of methotrexate, particularly when administered at high doses. Common cutaneous manifestations of methotrexate toxicity include mucositis, photosensitivity, and severe immune reactions such as Steven-Johnson syndrome. However, localized skin reactions at the site of intrathecal administration have been scarcely reported in literature. This highlights a gap in the understanding and recognition of possible rare complications related to the administration method of this chemotherapy agent.
Case Report of Skin Reaction
The case presented discusses a 24-year-old female patient with ALL who developed a skin lesion resembling a burn at the site of intrathecal methotrexate administration. Following the treatment regimen of hyper CVAD protocol, which included intrathecal methotrexate (12.5 mg), the patient presented with a dusky erythematous patch measuring 4 cm by 6 cm at the administration site. No history of trauma was noted, indicating that the reaction was possibly linked to the treatment itself. The patient was successfully treated with silver sulfadiazine cream and wound dressing, showing significant improvement within a week.
Treatment of Skin Reactions
In treating skin reactions associated with intrathecal methotrexate, various protocols have been applied in the medical literature. Standard treatments may incorporate steroids or antihistamines, as well as supportive care involving emollients and dressings. In this case, the treatment approach involved applying silver sulfadiazine cream twice daily, which proved effective in promoting healing of the lesion without further complications during the patient's ongoing chemotherapy regimen.
Conclusion
Although intrathecal administration of methotrexate is a critical component of treatment for ALL, clinicians must remain vigilant for rare but serious complications such as localized skin reactions. This case emphasizes the importance of recognizing and addressing such adverse effects promptly, utilizing appropriate treatments to mitigate complications. Enhanced awareness and further research into the cutaneous effects of intrathecal methotrexate are warranted to improve patient outcomes and ensure safe administration practices.
FAQ section (important questions/answers):
What is the main complication from intrathecal methotrexate discussed in the study?
The study highlights a rare complication: a burn-like skin lesion at the site of intrathecal methotrexate administration.
Who is the patient discussed in the case report?
A 24-year-old female patient diagnosed with acute lymphoblastic leukemia (ALL) is presented in this case report.
What treatment did the patient receive for her condition?
The patient was treated with a hyper CVAD protocol, along with intrathecal methotrexate and cytarabine as CNS prophylaxis.
How was the skin lesion treated in this case?
The skin lesion was treated with silver sulfadiazine cream and cefratol wound dressing, resulting in improvement within a week.
Are cutaneous reactions common with methotrexate treatment?
While cutaneous reactions can occur, skin reactions specifically at the intrathecal injection site are extremely rare.
What prior case is referenced regarding skin reactions from intrathecal methotrexate?
The study references a case by Forner et al., detailing a similar skin reaction in a 23-year-old woman with diffuse large B-cell lymphoma.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Skin reaction at site of intrathecal methotrexate”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Burning (Burn, Burned, Burnt):
Burn refers to the skin reaction characterized by damage resulting from heat, chemicals, or radiation. In the context of intrathecal methotrexate administration, a burn-like skin reaction is an uncommon adverse effect that can lead to pain and requires appropriate medical treatment to heal, highlighting its potential seriousness.
2) Chemotherapy:
Chemotherapy is a treatment method that uses powerful drugs to kill cancer cells or inhibit their growth. In this case, methotrexate is utilized as part of the chemotherapy protocol for acute lymphoblastic leukemia, showcasing its critical role in managing hemato-oncological diseases.
3) Dressing:
Dressing refers to a sterile covering applied to a wound or skin lesion to promote healing and prevent infection. In the reported case, cefratol wound dressing was used to cover the burn-like lesion, emphasizing the importance of proper wound care in oncology treatment protocols.
4) Knowledge:
Knowledge in this context refers to the understanding and awareness of medical conditions and their treatment-related complications. The rarity of burn-like reactions following intrathecal methotrexate administration indicates the importance of sharing knowledge among healthcare providers for better patient care and management.
5) Silver:
Silver in this medical context specifically refers to silver sulfadiazine, a topical antibiotic cream used for burn treatment. Its application in the featured case demonstrates its effectiveness in preventing infection and promoting healing in burn-like skin reactions, underlining the role of specific treatments in clinical care.
6) Discussion:
Discussion indicates an examination of findings, implications, and practices. In this report, the discussion section analyzes the case of skin reactions to intrathecal methotrexate, connecting it to existing literature and underscoring the need for further investigation into rare side effects of chemotherapy.
7) Toxicity:
Toxicity refers to the degree to which a substance can harm organisms. In the realm of chemotherapy, methotrexate is associated with various toxicities, including skin reactions, illustrating the need to monitor and manage adverse effects in cancer treatment to ensure patient safety.
8) Medicine:
Medicine refers to the science and practice of diagnosing, treating, and preventing diseases. This article highlights the use of medicine, specifically chemotherapy, in treating acute lymphoblastic leukemia, while also addressing the complexities and risks associated with pharmacological interventions.
9) Vomiting:
Vomiting is the involuntary expulsion of stomach contents through the mouth. In the reported patient's symptoms, persistent vomiting can indicate the side effects of chemotherapy, emphasizing the need for supportive care and symptom management in cancer treatment to improve the patient's quality of life.
10) Disease:
Disease refers to a pathological condition of a bodily part or system resulting from various causes. In this case, acute lymphoblastic leukemia is emphasized as a significant concern in oncology, indicating the critical need for effective treatment interventions to combat such malignancies.
11) Nausea:
Nausea is the sensation of an urge to vomit often experienced during chemotherapy. This symptom appears in the case report, highlighting the challenges faced by patients undergoing cancer treatment and the importance of managing side effects to ensure treatment adherence.
12) Rasa (Rasha):
Rasha refers to one of the authors involved in this study. Her inclusion in the research signifies collaboration in the medical field, enhancing the quality of clinical investigations and literature related to patient care, particularly in oncology and hematology.
13) Fever:
Fever is characterized by an elevated body temperature and can indicate an underlying infection or inflammatory response. In the context of this patient's symptoms, fever can be a notable side effect of chemotherapy or associated health issues, necessitating prompt medical evaluation.
14) Study (Studying):
Study refers to the systematic investigation of a subject to discover or revise facts. This case report contributes to the body of literature on the rare side effects of intrathecal methotrexate administration, underlining the importance of ongoing research in oncology.
15) Drug:
Drug refers to any substance used in the diagnosis, treatment, or prevention of disease. In this case, methotrexate stands out as a crucial drug for treating acute lymphoblastic leukemia, highlighting the significance of pharmacological agents in managing cancer effectively.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Skin reaction at site of intrathecal methotrexate’. Further sources in the context of Science might help you critically compare this page with similair documents:
Central nervous system, Wound dressing, Cutaneous manifestations, Skin lesion.