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This study explores methotrexate treatment for refractory Hailey-Hailey disease. The findings suggest methotrexate may offer an alternative therapeutic option for this chronic skin condition.

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Area of Science:

  • Dermatology
  • Immunology

Background:

  • Hailey-Hailey disease (HH) is a chronic, relapsing blistering skin disorder.
  • Treatment resistance is common in HH, necessitating exploration of alternative therapies.

Observation:

  • A 58-year-old woman with a 31-year history of refractory HH disease presented for new treatment options.
  • The patient exhibited active, eroded, and crusted plaques in intertriginous areas.

Findings:

  • The patient was treated with oral methotrexate (10-15 mg/week) and folic acid supplementation for 3 years.
  • Intermittent clarithromycin and prednisone were used for antibacterial and anti-inflammatory effects.

Implications:

  • Methotrexate may represent a viable alternative treatment for recalcitrant Hailey-Hailey disease.
  • Further research is warranted to establish the efficacy and safety of methotrexate in HH management.