Efficacy and Safety of add-on Dapsone Versus add-on Methotrexate in Patients With Bullous Pemphigoid

Exclusion Criteria

• •Patients on any steroid-sparing agents within one month of recruitment.
• •Treatment with a systemic corticosteroid, sulfones, within the last week.
• •Patients with Glucose 6 phosphate dehydrogenase deficiency.
• •Decreased liver or renal function (creatinine \> 2.0mg/dl, total bilirubin \> 2.5 mg/dl).
• •Severe acute infection, severe diabetes mellitus, untreated glaucoma, congenital or acquired immunodeficiency, active gastroduodenal ulcer, severe osteoporosis, severe cardiac disease (NYHA grade IV), MI in the last four weeks, severe schizophrenia or depression.
• •Malignancies treated by cytotoxic or immunosuppressive medications.
• •Anaemia (Hb \<9 gm/dl), leucopenia (\< 3 ×10 9 cells /L) or thrombocytopenia (\< 100 × 10 9 cells/ L), and H/O porphyria.
• •Patient with a history of hypersensitivity to Methotrexate or Dapsone.
• •Vaccination in the last two weeks.
• •Patients with HIV, Hepatitis B, and C infection.
• •Pregnancy and lactation, women of childbearing age without effective contraception.