Methotrexate for the treatment of severe mucocutaneous lupus erythematosus.

We report three women with severe, chronic mucocutaneous lupus erythematosus who showed a significant improvement during oral methotrexate therapy; the improvement was sustained after the drug was discontinued. Their disease had previously been refractory to a wide range of conventional systemic immunosuppressive therapies. Other treatments were progressively withdrawn, and control was maintained, for a variable length of time, with methotrexate alone, or with a small dose of prednisolone.