A 37-year-old man with ankylosing spondylitis (AS) and psoriasis who was successfully treated with methotrexate (MTX) is reported. In 1980, he had low back pain, limited motion in the lumbar spine, radiological findings of bilateral sacroiliitis, and HLA-B27 positivity. In January 1991, he developed psoriasis and he had difficulty in performing desk work in spite of treatment with antirheumatic drugs. In May 1991, MTX 7.5 mg/week per os was started. Joint symptoms, psoriasis, and acute phase reactants improved within 1 month after the treatment and this improvement continued for more than 6 months after the treatment. After discharge he was able to return to his job.
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