Abstract
Summary The results are presented of parenteral treatment with methotrexate (12·5 mg. twice a week) in 19 cases of various forms of pemphigus; small doses of corticosteroids (usually 8–32 mg. daily) were given in addition. Two other cases, both of pemphigus erythematosus, were treated with azathioprine. The response to immunosuppressants was good, chiefly in pemphigus erythematosus. In pemphigus vulgaris. cutaneous lesions responded much better than mucosal ones, which in some cases improved only some weeks after discontinuation of the treatment with methotrexate. Locally applied corticosteroids proved to be very valuable. Attention is called to the large number of complications, chiefly bacterial infections due to the lowering of the resistance of the organism in general. Methotrexate cannot be regarded as completely safe, and it would be premature to try to evaluate its long–term results in comparison with those of corticosteroid therapy alone.
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