The use of methotrexate for treating childhood atopic dermatitis: a multicenter retrospective study

Background: Atopic dermatitis is a chronic inflammatory skin disease. Methotrexate is an off-label systemic agent for treating uncontrolled atopic dermatitis. Objective: This study assessed the safety and efficacy of methotrexate in pediatric patients with atopic dermatitis. Methods: This multicenter, retrospective study assessed pediatric patients with atopic dermatitis who were treated with methotrexate. Results: Medical records of 26 pediatric patients with atopic dermatitis were reviewed. All the patients had Investigator Global Assessment (IGA) scores of 3–4 and had received systemic therapy before receiving methotrexate. In all, 53.85% patients showed clinical improvement at 3 and 6 months after methotrexate initiation. The IGA scores of the patients decreased significantly at 3 months after methotrexate initiation compared with those at baseline; moreover, the IGA scores of the patients at 6 months after methotrexate initiation were lower than those at 3 months after methotrexate initiation. In all, 54% study patients are still undergoing methotrexate treatment. Median satisfaction rate with methotrexate was 7.5/10. However, 10.35% patients developed adverse events, of which only one patient discontinued the treatment. Conclusions: Our results indicate that methotrexate is a tolerable and effective agent for treating refractory childhood atopic dermatitis.