Therapeutic Effect of Low-dose Methotrexate on Lymphomatoid Papulosis

Lee, Deuk Pyo; Oh, Sang Hyun; Chang, Sung Eun; Lee, Mi Woo; Choi, Jee Ho; Moon, Kee Chan; Koh, Jai Kyoung

Abstract

BACKGROUND
The treatment of patients with lymphomatoid papulosis is unsatisfactory. Because a curative therapy is not available and none of the available treatment modalities affects the natural course of the disease, the short-term benefits of active treatment should carefully be balanced against the potential side effects. OBJECTIVE: The purpose of this study was to determine the effectiveness and safety of methotrexate in the treatment of lymphomatoid papulosis. METHOD: Twelve patients with a clinicopathological diagnosis of lymphomatoid papulosis were treated with low-dose methotrexate (5-20mg/week), and clinical efficacy and adverse effects were evaluated. RESULTS: The male-to-female ratio was 1: 1.4, and age distribution ranged from 11 to 65 years, with a mean age of 41 years. Histopathologic types classified by Willemze's classification included type A (10 cases), type B (0 cases), and type C (2 cases). All patients responded to low-dose methotrexate, and the level of control was judged to be `excellent' (no or rare lesions between doses), `good' (few lesions between doses), `fair' (improvement but new lesions continued to develop), or `poor' (no improvement observed) in 7 (58%), 2 (17%), 3 (25%), and 0 (0%) of patients respectively. All three patients in the `fair' group (the group relatively less responsive to methotrexate) were female and included both patients who were histopathologic type C. Adverse effects only included nonspecific gastrointestinal discomfort in two patients. CONCLUSION: Low-dose methotrexate (5-20mg/week) is effective and well-tolerated in most patients with lymphomatoid papulosis.