To the Editor.—
Dermatologists who choose to use methotrexate for treating severe psoriasis vulgaris find themselves in a dilemma as pointed out by Robert Burns, MD. In a recent survey1 of dermatologists in private practice and in university training centers, the lack of approval of methotrexate by the FDA was a major reason for discontinuation of its use in psoriasis.The fact that methotrexate has only been approved for treatment of various neoplasms and not for treatment of psoriasis was recently examined by the Honorable L. H. Fountain's Intergovernmental Relations Subcommittee in Washington, DC, July 29 and 30, 1971. Mr Fountain pointed out that methotrexate as a drug for treatment of psoriasis, even though never approved by the Food and Drug Administration, has nevertheless not been actively opposed by the FDA. The FDA, in defense of their position as given in testimony by James D. Grant, Deputy Commissioner of
Roenigk HH. Drugs and Their Use-Reply. Arch Dermatol. 1972;105(1):127–128. doi:10.1001/archderm.1972.01620040087026
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