We read with great interest the article by Enk and Knop1 and the accompanying editorial by Stanley.2 We were very impressed with the dramatic and rapid improvement obtained in 12 patients with pemphigus vulgaris with the use of mycophenolate mofetil, 2 g/d, as a steroid-sparing immunosuppressive agent. However, based on our own experience treating patients with autoimmune and inflammatory skin diseases, we feel that there are 3 aspects of this article that deserve further discussion and comment.