Friday, July 21, 2017

Psoriasis - My Dermatologist Visit

I saw the dermatologist on Wednesday. I believe it went really well. Thankfully I had written down all of the medications I had used over the years. At least the ones I could remember any way. It was quite a long list too. So I could let her know what I had tried previously. I am not sure if she was a little surprised or not about some of the things I have used. Especially when she made comments like, you did that yourself at home? I am guessing that dithranol isn't usually applied at home.

She then checked out my skin, the part I hate but of course you have to show your best side right , and gave me my PASI (Psoriasis Area and Severity Index) score = 20.7, which is moderate to severe. Here I was thinking that it wasn't too bad because I can still see lots and lots of good skin. To be honest I have had a lot worse with around 80% coverage a few years ago.

Then I got the usual explanations of topical, photo-therapy, medications and biologics treatments. She stated that biologics are the future BUT in Australia you need to have tried at least 3 things and have them fail or not work as effectively in order to qualify for the biologics.

Due to the years of UVB treatment I have had in the past she stated that I no longer have that as an option. So I need to try either methotrexate (mtx) or cyclosporin. I have used mtx in the past and went okay on that, at least what I can remember. The only problem I had was my liver function test showed something funky and I needed to stop taking it.

The derm would like me to try mtx but will keep a close eye on my liver function. I need to get some blood tests done before I can start. Once they are done and she has checked the results to see that everything is okay she will send me my prescription. The only thing I need to do whilst on this treatment is take folic acid & of course use the topical ointments she prescribed. It's meant to help with the possible nausea and vomiting that might occur, lucky me. Hopefully I will be able to start next week.

I go back and see her in three months time. In the meantime I can email her as needed. 

All I keep thinking is yay I have a modern thinking dermatologist who is open to using things other than old fashioned stinky tar based lotion. I like this new doctor! Please cross your fingers and toes for me that everything is well with my tests and that I get the go ahead for this treatment.
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