Ocular cicatricial pemphigoid: Methotrexate as an initial treatment?

Reumatol Clin (Engl Ed). 2022 Jan;18(1):30-32. doi: 10.1016/j.reumae.2020.10.003. Epub 2021 Jun 2.


Objective: To analyse the clinical/epidemiological data, the management and the treatments established in patients with Ocular Cicatricial Pemphigoid (OCP) in a Rheumatology Service.

Material and methods: Review of clinical histories of patients with OCP referred by ophthalmology between 2008 and 2019.

Results: In our series of 27 patients, 67% were diagnosed and referred in the last 2 years. Most in Foster stage 1. Of the patients, 18.5% presented associated Sjogren's syndrome, with poor progression: 88.8% received Methotrexate, 74% used it as monotherapy and 66% continued with said treatment up to the end. Eighteen point five percent had to combine or rotate therapies, the drugs used were mycophenolate, azathioprine, cyclophosphamide, sirolimus, etanercept, rituximab: 29% used steroids. Only in 2 eyes was stage progression observed. There were no serious adverse events, and 37% had mild adverse events.

Conclusion: Starting immunosuppressive therapy early is essential, methotrexate being a good initial alternative in our experience, and treatment must be escalated in line with disease progression.

Keywords: Methotrexate; Metotrexato; Ocular cicatricial pemphigoid; Penfigoide ocular cicatricial; Tratamiento; Treatment.

Publication types

  • Case Reports

MeSH terms

  • Azathioprine
  • Cyclophosphamide / adverse effects
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Methotrexate* / adverse effects
  • Pemphigoid, Benign Mucous Membrane* / diagnosis
  • Pemphigoid, Benign Mucous Membrane* / drug therapy


  • Immunosuppressive Agents
  • Cyclophosphamide
  • Azathioprine
  • Methotrexate