Intralesional methotrexate in dermatology: diverse indications and practical considerations

Tamara Searle, Faisal R Ali, Firas Al-Niaimi

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12 Citations (Scopus)
230 Downloads (Pure)


Intralesional methotrexate (IL-MTX) is a long-established treatment, which is arguably underutilized by dermatologists. We describe the underlying evidence base and practical considerations for its broad range of cutaneous indications, including in cutaneous oncology (keratoacanthomas, squamous cell carcinomas, lymphomas), inflammatory dermatology (nail psoriasis, plaque psoriasis, pyoderma gangrenosum, cutaneous Crohn's disease, amyloidosis), cutaneous infections (viral warts) and for treatment of filler complications. In certain circumstances, IL-MTX can be more efficacious and less invasive than other treatments, with fewer adverse effects. Dermatologists should consider using IL-MTX for a range of recalcitrant cutaneous conditions, particularly for those patients not amenable to surgery or systemic therapy.

Original languageEnglish
Article numbere14404
JournalDermatologic Therapy
Issue number1
Number of pages8
Publication statusPublished - Feb 2021


  • Intralesional
  • Keratoacanthoma
  • methotrexate
  • squamous cell carcinoma
  • warts


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