Psoriasis treatment: Unconventional and non-standard modalities in the era of biologics

Table 2 Adverse effects of methotrexate therapy

System involved	Adverse effects
General	Fatigue, headaches, chills and fever, dizziness
Skin	Pruritus, pain and burning, urticaria, mild reversible alopecia, ecchymosis, acute ulcerations of psoriatic lesions, reactivation of phototoxic responses
Blood	Bone marrow depression, leukopenia leading to decreased resistance to infection, anemia, thrombocytopenia, bleeding, and megaloblastic anemia, Pancytopenia
Gastrointestinal system	Nausea and anorexia, diarrhea, vomiting, ulcerative stomatitis, pharyngitis, enteritis
Urinary system	Azotemia, microscopic hematuria, cystitis, nephropathy
Respiratory system	Acute pneumonitis, pulmonary fibrosis
Nervous system	Headaches, dizziness, drowsiness, blurred vision, acute depression
Reproductive system	Teratogenesis, defective oogenesis, menstrual dysfunction, reversible oligospermia, defective spermatogenesis
Uncommon side effects	Anaphylaxis, acral erythema, epidermal necrosis, vasculitis, osteopathy, lymphoma