Twenty-four of 36 patients with pemphigus vulgaris were treated with methotrexate alone or in various combinations with prednisone, All 24 patients were living and in good condition when reexamined on Sept 1, 1971. Eight patients were free of lesions, whereas 16 patients still had some lesions, predominantly in the mouth. It seems that in patients who receive a regimen of methotrexate in the early phase of the disease the need for, or length of, highdosage treatment with prednisone is reduced. In patients with advanced disease in whom the disease has been brought under control by high-dosage treatment with prednisone, smaller maintenance doses of prednisone usually are possible when methotrexate is also administered. Methotrexate therapy in weekly doses of 20 to 50 mg caused no serious complications. Oral lesions respond much less readily than cutaneous lesions to methotrexate.
Lever WF. Methotrexate and Prednisone in Pemphigus VulgarisTherapeutic Results Obtained in 36 Patients Between 1961 and 1970. Arch Dermatol. 1972;106(4):491-497. doi:10.1001/archderm.1972.01620130023006