A retrospective analysis of patients with bullous pemphigoid treated with methotrexate.

OBJECTIVES To evaluate treatment with methotrexate in patients with bullous pemphigoid and to elucidate the reduced adverse effects compared with standard treatment with prednisone. DESIGN Retrospective study (January 1, 1999-December 31, 2003). SETTING The Department of Dermatology and Venerology, Karolinska University Hospital. PATIENTS A total of 138 consecutive patients with bullous pemphigoid were included and were grouped according to the treatment they received: methotrexate, prednisone, a combination of both, or topical glucocorticoids (for mild disease). RESULT Methotrexate was the most effective treatment, with only a few adverse effects and a tendency toward better survival rates in patients with moderate to severe disease. CONCLUSION Methotrexate is an effective and safe drug and provides an excellent treatment option in patients with bullous pemphigoid.