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Rheumatology Advance Access originally published online on September 6, 2009
Rheumatology 2009 48(11):1465; doi:10.1093/rheumatology/kep259
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© The Author 2009. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Comment on: Liver fibrosis in patients with psoriasis and psoriatic arthritis on long term, high cumulative dose methotrexate therapy: reply

Karen Lindsay1, Andrew Gough1, Alison Layton2 and Sandy Fraser3

1Department of Rheumatology, 2Department of Dermatology, Harrogate District Hospital, Harrogate and 3Department of Rheumatology, Leeds Teaching Hospital NHS trust, Leeds, UK

Correspondence to: Karen Lindsay, Department of Rheumatology, Harrogate District Hospital, Harrogate HG2 7SX, UK. E-mail: karen.lindsay@middlemore.co.nz

The first 10% of the full text of this article appears below.

SIR, I would like to thank Dr Boffa et al. [1] for their response to our article. It highlights an important area where dermatologists and rheumatologists encounter problems in optimally and safely co-managing the most difficult patients with psoriasis and PsA, i.e. those with active disease. There have been historical differences in practice with regards to the safe monitoring of liver toxicity in long-term MTX use. We tend to make the assumption that patients with psoriatic skin . . . [Full Text of this Article]


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