Five patients with pemphigus vulgaris were treated with the immunosuppressive drug, methotrexate. Treatment was effective in three patients in whom the disease previously had been held in nearly complete remission by maintenance doses of prednisone. Also, good results were obtained in one patient who was in the very early stage of the disease. The toxicity of methotrexate limited, however, its usefulness in one patient with very active pemphigus vulgaris since very high doses appear to be necessary for an adequate control of the disease.
Lever WF, Goldberg HS. Treatment of Pemphigus Vulgaris With Methotrexate. Arch Dermatol. 1969;100(1):70-78. doi:10.1001/archderm.1969.01610250076018