Abstract: A case of refractory pemphigus vulgaris treated with oral tacrolimus combined with glucocorticoid was reported. A 55-year-old male was diagnosed with pemphigus vulgaris and  treated with methylprednisolone 64 mg, once a day and tacrolimus 1 mg, twice a day, and other symptomatic treatments. The erosion surface healed after treatment for 5 weeks and the patient was discharged. The discharge medication included methylprednisolone 60 mg/d, in two doses and tacrolimus 1 mg, twice a day, and the Dsg1 antibody and Dsg3 antibody became negative after 8 months. Then methylprednisolone was reduced to 15 mg, once a day, and tacrolimus 1 mg once a day. The patient is still followed up.

Key words: tacrolimus, methylprednisolone, pemphigus vulgaris