The classic treatment of bullous pemphigoid (BP) has been systemic corticosteroid therapy, which has recently been replaced by potent topical corticosteroid therapy,1 but such treatment has required a hospital stay or an extended nursing period. The use of other medications has been suggested, but their efficacy remains unproved.
An open, prospective, noncomparative study was undertaken to assess the efficacy of methotrexate in the treatment of BP. From November 2000 to April 2002, all patients who were admitted to the Department of Dermatology, Centre Hospitalier, Le Mans, France, with BP were treated with methotrexate. The diagnostic criteria were as follows: clinical findings,2 subepithelial blister, and positive findings on immunofluorescence microscopy. If the clinical findings suggested BP, oral methotrexate therapy (10 mg/wk) was initiated.