An Indian retrospective chart study analyzed the efficacy and safety of methotrexate in severe childhood psoriasis. Records of 24 patients aged <18 years from 1993-2006 were retrieved from one institute. Response to treatment was graded as good (50-75% decrease in the Psoriasis Area and Severity Index, or PASI) and excellent (>75% decrease in the PASI score). Laboratory tests to monitor methotrexate toxicity were done at regular intervals. Response to treatment was "excellent" in 22 cases and the mean time to 50% reduction in the PASI was 5.1 weeks. The duration of remission varied from 1.5 months to 3 years based on 9 evaluable patients. Mild side effects were observed in 9 patients ...