Conventional adjuvant treatments do not consistently permit steroid therapy to be discontinued in patients with chronic pemphigus vulgaris (PV).1,2 Methotrexate therapy, which was reported to be effective,3,4 has been largely abandoned because of concerns about toxic effects.1,2 This might have resulted from the high dosages (up to 150 mg/wk) of methotrexate used together with high dosages of steroids. We describe the efficacy of low dosages of methotrexate in patients taking low to moderate dosages of steroids.
Smith TJ, Bystryn J. Methotrexate as an Adjuvant Treatment for Pemphigus Vulgaris. Arch Dermatol. 1999;135(10):1275-1276. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-10-dlt1099