Bullous pemphigoid (BP), the major autoimmune subepidermal bullous disease, is classically a steroid-responsive disorder and is widely treated with systemic, mainly oral, corticosteroids,1 although various therapeutic agents have been used to avoid systemic steroids, such as oral cyclins, dapsone, or topical superpotent (class I) steroids.2 Methotrexate has already been used in autoimmune bullous diseases, such as pemphigus vulgaris, usually in association with corticosteroids in this last condition.3 In BP, only 2 small series and some isolated cases are available regarding treatment with methotrexate alone, whether administered after initial use of systemic or topical steroids,4,5 with promising clinical results as to the efficiency-tolerance ratio. We report herein our experience of low-dose methotrexate monotherapy in the maintenance of a clinical remission induced by an initial and short use of local, potent steroids in an open series of 18 elderly patients with BP.
Dereure O, Bessis D, Guillot B, Guilhou J. Treatment of Bullous Pemphigoid by Low-Dose Methotrexate Associated With Short-term Potent Topical Steroids: An Open Prospective Study of 18 Cases. Arch Dermatol. 2002;138(9):1255-1256. doi:10.1001/archderm.138.9.1251