{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T20:05:14Z","timestamp":1780344314834,"version":"3.54.1"},"reference-count":16,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2002,6,1]],"date-time":"2002-06-01T00:00:00Z","timestamp":1022889600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2002,6]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To report a case of skin ulceration as a result of treatment with leflunomide for rheumatoid arthritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CASE SUMMARY:<\/jats:title>\n                    <jats:p>A 78-year-old white woman developed bilateral leg ulcers after 6 months of treatment with leflunomide for rheumatoid arthritis. A history of leg ulcers after methotrexate therapy had been documented. Serologic and diagnostic tests did not support an alternate process. Other medications prescribed were oral ethinyl estradiol 0.05 mg\/d, felodipine 5 mg\/d, and paroxetine 20 mg\/d, for which no documented correlation with the skin breakdown could be made.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>This is the first published case describing a possible relationship between the use of the immunosuppressant agent leflunomide and skin ulceration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Skin breakdown and ulceration is a recognized adverse effect of drugs with immunosuppressant activity such as methotrexate. Leflunomide, a newer agent prescribed in the treatment of rheumatoid arthritis, may now be listed among the drugs in this category associated with this adverse drug effect.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1a347","type":"journal-article","created":{"date-parts":[[2003,6,4]],"date-time":"2003-06-04T16:23:41Z","timestamp":1054743821000},"page":"1009-1011","source":"Crossref","is-referenced-by-count":29,"title":["Leflunomide-Associated Skin Ulceration"],"prefix":"10.1177","volume":"36","author":[{"given":"Christopher M","family":"McCoy","sequence":"first","affiliation":[{"name":"Christopher M McCoy BSPharm PharmD, Assistant Professor, Department of Pharmacy Practice, Bouve College of Health Sciences, Northeastern University, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2002,6,1]]},"reference":[{"key":"bibr-bibr1-aph.1A347","doi-asserted-by":"publisher","DOI":"10.1345\/aph.17300"},{"key":"bibr-bibr2-aph.1A347","first-page":"2290","volume":"27","author":"Montero LC","year":"2000","journal-title":"J Rheumatol"},{"key":"bibr-bibr3-aph.1A347","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1990.01670330098016"},{"key":"bibr-bibr4-aph.1A347","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(91)70295-D"},{"key":"bibr-bibr5-aph.1A347","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198903303201307"},{"key":"bibr-bibr6-aph.1A347","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1975.01630200080009"},{"key":"bibr-bibr7-aph.1A347","doi-asserted-by":"publisher","DOI":"10.1016\/0741-5214(91)90251-O"},{"key":"bibr-bibr8-aph.1A347","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.314.7086.1019"},{"key":"bibr-bibr9-aph.1A347","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/40.7.816"},{"key":"bibr-bibr10-aph.1A347","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"},{"key":"bibr-bibr11-aph.1A347","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)09403-3"},{"key":"bibr-bibr12-aph.1A347","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780381111"},{"key":"bibr-bibr13-aph.1A347","unstructured":"McEvoy GK, ed. American Hospital Formulary Service drug information. Bethesda, MD: American Society of Health-System Pharmacists, 2002: 3670\u20136."},{"key":"bibr-bibr14-aph.1A347","volume-title":"Arava (leflunomide)","year":"2000"},{"key":"bibr-bibr15-aph.1A347","first-page":"238","volume":"13","year":"1999","journal-title":"Who Drug Information"},{"key":"bibr-bibr16-aph.1A347","doi-asserted-by":"publisher","DOI":"10.1016\/0014-5793(93)81704-4"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1A347","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1A347","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:05:44Z","timestamp":1777374344000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1345\/aph.1A347"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,6]]},"references-count":16,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2002,6]]}},"alternative-id":["10.1345\/aph.1A347"],"URL":"https:\/\/doi.org\/10.1345\/aph.1a347","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,6]]}}}