Lymphomatoid Papulosis and Low-Dose Methotrexate

Although most patients with LyP don't need systemic treatment, methotrexate is generally effective and safe for those who do.

Lymphomatoid papulosis (LyP) is one of the primary cutaneous CD30+ lymphoproliferative disorders. Although the histology of papules and nodules suggests lymphoreticular malignancy, the lesions usually follow a benign course, often resolving spontaneously. Low-dose methotrexate may be effective in allowing lesions to heal and in preventing new ones from forming.

Now, investigators in the Netherlands have reviewed the results of such therapy in 28 LyP patients seen at one of two medical centers (~10% of all patients with LyP treated at these centers between 1994 and 2014). All had widespread necrotic papules and nodules, cosmetically “disturbing” ulcerating and scarring lesions, or both. The starting dose of methotrexate was 5 to 25 mg/week (m…

Reviewing Author

Mark V. Dahl, MD

Disclosures

Consultant / Advisory board Ulthera, Inc.; AuBio LifeSciences, LLC; Paris Therapeutics

Equity Elorac, Inc.; Makucell, Inc.; Paris Therapeutics

Editorial boards UpToDate

Leadership positions in professional societiesNational Rosacea Society (Chairman, Medical Board)