Rheumatoid Arthritis Research Today is a free monthly online journal that collates and summarizes the latest research about Rheumatoid Arthritis, including details on treatment, symptoms, causes, medication.

Methotrexate-associated lymphoproliferative disorder in a patient with rheumatoid arthritis presenting in the skin.

Clarke LE, Junkins-Hopkins J, Seykora JT, Adler DJ, Elenitsas R

Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, USA. lorenclarke@comcast.net

A 91-year-old woman who had been taking methotrexate for approximately 5 years for rheumatoid arthritis developed papules and nodules on her face that enlarged during 6 months. A series of biopsy specimens demonstrated a lymphoplasmacytic infiltrate with increasingly atypical histopathologic features that resembled diffuse large B-cell lymphoma. Epstein-Barr virus was not identified. Withdrawal of methotrexate resulted in complete resolution of all lesions within 8 weeks. This case illustrates the rare occurrence of methotrexate-associated lymphoproliferative disorder with primary presentation in the skin and documents clinical and histopathologic progression from early changes to fully developed lesions.

Published 19 March 2007 in J Am Acad Dermatol, 56(4): 686-90.
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