@article{oai:dmu.repo.nii.ac.jp:00005365,
 author = {Katagiri, Kazumoto and Shinohara, Kana and Ichimasu, Nao and Yamazaki, Marina and Kawai, Rana and Shimura, Chieko and Suyama, Takayuki},
 issue = {4},
 journal = {Dokkyo Medical Journal},
 month = {Dec},
 note = {We report three cases of methotrexate (MTX) -induced oral erosions and ulcers mimicking Stevens-Johnson syndrome (SJS) in older women with rheumatoid arthritis, although they did not had conjunctivitis. Furthermore, age, dehydration, and renal dysfunction could trigger adverse reactions of MTX, but one patient underwent dialysis, which is a contraindication for MTX. It is sometimes very difficult to differentiate the toxicity of MTX from SJS. Learning from the three cases, we propose that oral mucosal erosions without conjunctive mucosal inflammation, leukopenia, and thrombocytopenia differentiate MTX toxicity from SJS. Furthermore, our patients nearly recovered from myelosuppression within seven days and recovered from mucosal erosions characteristic of MTX toxicity within 14 days. These clinical courses could also be characteristic for MTX toxicity rather than SJS, although quick recovery does not happen in all cases. Therefore, physicians who prescribe MTX must accurately know MTX-induced adverse reactions to recognize them early. Furthermore, as seen in our patients, oral mucosal erosions occur often. Therefore, dermatologists or others who examine these symptoms should consider that mucosal erosions mimicking SJS could be an adverse reaction of MTX, regardless of whether or not SJS/toxic epidermal necrolysis is suspected.},
 pages = {351--355},
 title = {Three Cases of Methotrexate-induced Oral Erosion and Ulcers without Conjunctivitis Mimicking Stevens-Johnson Syndrome},
 volume = {1},
 year = {2022}
}