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Treatment of Pemphigus Vulgaris With Immunosuppressives (Steroids and Methotrexate) and Leucovorin Calcium

Samuel M. Peck, MD; Kermit E. Osserman, MD; Arthur J. Samuels, PhD; Bernard W. Berger, MD; Ruth S. Osserman

Arch Dermatol. 1971;103(2):141-147.

Abstract
Thirteen patients with pemphigus vulgaris were treated over a period of months or years with a combination of steroids and methotrexate. Antiepithelial antibodies were reduced in titer with the administration of these drugs. In ten of 13 patients side effects of methotrexate were quite severe despite low dosages. Methotrexate in adequate amounts would have been discontinued had not the use of leucovorin calcium, the specific antidote for methotrexate, been added as part of therapy. When leucovorin calcium was administered at intervals of one-half to three hours after injection of methotrexate, immunosuppressive action of methotrexate could be maintained in a majority of patients. In our experience flexibility in administration of the use of methotrexate alone or in combination with steroids and leucovorin calcium is recommended in the treatment of pemphigus.

Author Affiliations
New York

From the departments of dermatology (Drs. Peck and Berger) and medicine (Drs. Osserman and Samuels and Miss Osserman) and Myasthenia Gravis Clinic and Research Laboratory, Mount Sinai School of Medicine, City University of New York, New York.

Footnotes
Accepted for publication Sept 22, 1970.

Read in part before the Atlantic Dermatological Conference, New York, April 18, 1970.

Reprint requests to Mount Sinai Hospital, Falk 600-D, Fifth Ave and 100th St, New York 10029 (Miss Osserman).

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