Methotrexate for urticarial vasculitis.

A patient with urticarial vasculitis unresponsive to all treatments except systemic corticosteroids responded completely to low-dose oral methotrexate, allowing withdrawal of corticosteroids. Methotrexate is a proven treatment for other immunologic diseases, and low doses seem to carry an acceptable safety profile. Its use in urticarial vasculitis may be appropriate in selected patients.