Three male and four female patients aged 14 to 40 years were treated for recurrent pharyngeal ulcer with antiallergic drugs, such as azelastine hydrochloride, and the local application of antiseptic medication (povidone -iodine). For acute or severe conditions, antibiotics, non-steroid anti-inflamatory medication and topical corticosteroids were added . S ystemic corticosteroid therapy was given only to patients who failed to respond to the above medications
Six patients have been free of disease for 3 months to 13 years . One of them, a 19-yearold male, was resistant to all the above drugs and required high doses of corticosteroids, so we treated him with low-dose methotrexate (MTX). MTX was used in an oral pulse treatment schedule with 7.5mg per week . After 5 weeks, his ulcer was cured with scarring, and we could reduce the dose of corticosteroids while MTX was continued with minimal side effects. I t is concluded that MTX may have a role in reducing corticosteroid requirements in patients with steroid-dependent pharyngeal ulcer.
