Questions in The Dermatology Forum
are being answered by Dr. A. Rockoff, a board certified dermatologist, affiliated
with Tufts University School of Medicine.
Subject: Psoriasis Medication Topic Area: Psoriasis
Forum: The Dermatology Forum
Question Posted By: SleepyBear on Thursday, November 15, 2001
I am 34 y/o female and have had Psoriasis for about 14 years
now. The last five years have been severe. I've done all the PUVA's,
tars, creams, ointments and even tried Methotrexate. I was on MTX for
almost 2 years and recently stopped it cause my body started getting
a rash on top of my Psoriasis when the doc increased the dose to 6 pills
per week because of my arthritis. We tried to decrease it, but the rash
wouldnt go away and it was just too unbearable. I'm taking Vioxx for
the arthritis (seems to be working)- Celebrex wasn't strong enough.
I recently started taking Arava for the Psoriasis (25mg a day). I couldnt
find much on the net about this drug. Its been 2 months now and it has
not helped at bit (doc said it was a slow drug). My skin is worse than
it was before I started the MTX 2 years ago. I've always had it around
my face and forehead, but now its on my cheeks and my nose! That part
is hard to cover - even with makeup. I am going through a severe depression
because of it! The 2 years I was on MTX helped about clear me by 5%
and now all the clear spots are getting covered with Psoriasis and now
I have NEW spots. Its spreading to my fingers and to the palms of my
hands and feet! I am about 90% covered! And its very painful! It has
always been on my scalp and now thats worse. I thought about Soriatane,
but I dont have children and want them before I'm 40. From what I've
read, it is not a good drug anyway - way too many side effects. I have
several questions. What about Cyclosporine? Or any other drug for that
matter? Also, do you know of any kind of special make-up (or where I
can purchase some) to cover the lesions on my face?? I need medication
to get it under control fast so that I can have a life! My blood work
is fine. Liver is fine. But my skin is so extremely dry - worse than
it ever was before. I take 2 baths a day to help peel off the dry skin
and that helps but only for a several hours. I read yesterday that after
you stop taking MTX you have a severe flare up - I started feeling that
effect about a month ago! Wished I would have known that 2 years ago!
Any advice would be appreciated. PLEASE HELP!! I am desperate!
Answer Posted By: Derm-M.D.-ASR
on Thursday, November 15, 2001
You certainly seem to have an extraordinarily severe case of
a difficult disease. Nevertheless, there are some things you ought to
look into:
1. Facial psoriasis usually responds pretty well to
topical steroid creams. You should be able to minimize at least that
embarrassing aspect of your condition by regular application of one of
these preparations.
2. There is a new class of psoriasis drugs
about to be approved by the FDA. These target the immune sysytem,
specifically certain types of white blood cells. Reports are
encouraging, bith from the standpoint of safety and
effectiveness.
I suggest you consult with dermatologists familair
with these new treatments. You can find them at a teaching hospital or
academic medical center. Other resources include the National Psoriasis
Foundation (look for them on the web), a patient support group with an
informative website, or the American Academy of Dermatology
(www.aad.org.)
