Methotrexate (MTX) is a folate analogue having chemotherapeutic, immunosuppressant and antiinflammatory effects which is commonly used in rheumatoid arthritis (RA), psoriasis, lupus, sarcoidosis and eczema. The development of MTX toxicity are also associated with various risk factors. We present a case of a 54year old female with pancytopenia causing severe neutropenia, multiple oral mucocutaneous lesions and requiring intravenous antibiotic therapy, platelet transfusion as a result of continuous usage of low dose MTX for rheumatoid arthritis.

KEYWORDS: Methotrexate, Immunosuppressant, Anti-Inflammatory, Pancytopenia, Mucocutaneous lesions.