Reiter's syndrome. Treatment with methotrexate

Abstract

While the clinical course of Reiter''s syndrome may be marked by spontaneous remission and exacerbations, the severe course of the disease in these two patients continued essentially unabated until treatment with methotrexate was begun. The experience of Mullins and his associates likewise indicates that treatment with one of the folic acid antagonists may be beneficial in this disease. In our patients the joint manifestations as well as the skin eruption were controlled by the use of methotrexate. The use of the folic acid antagonist-type drugs in the treatment of psoriasis was recently reviewed by Rees and associates. They discuss the possible harmful side effects of this type of therapy which include bone marrow depression, superficial ulcerations of the gastrointestinal tract, and hypers ensitivity reactions such as urticaria and scarlatiniform eruptions. They point out that poor renal or liver function is a contrain-dication to therapy. They suggest that minimal criteria for the use of these drugs in psoriasis include severe, resistant, crippling, and incapacitating disease.