Methotrexate treatment for type 1 (reversal) leprosy reactions.

Corticosteroids are the drugs of choice for treatment of type 1 leprosy reactions, but when these agents cannot be used because of their adverse effects, alternative treatments are needed. We report the first case, to our knowledge, of a type 1 leprosy reaction that was successfully treated with methotrexate in a patient intolerant to corticosteroids who had borderline lepromatous leprosy.