Friday, March 23, 2018

Psoriasis Update


On Wednesday I had a review with my dermatologist. When I arrived I was told that she was running 45 minutes late. I thought that's okay I've got my kindle I'll just read. I finally managed to get in to see her an hour later. At least I got a lot of reading done!

My derm checked my skin to see how much or how little the methotrexate has helped me over the past few months. There has been improvement but I am still relying on the topical ointments and gels a great deal. If I miss using them I get a flare and it takes a bit longer for the spots/flakes to improve. 

For now I will be increasing my methotrexate from 20 mg a week to 30 mg. Which means I shall also need to have blood tests done in two weeks and then 8 weeks from now. Just to make sure that the methotrexate (mtx) isn't messing up my liver & kidney function etc. So far it hasn't and I have been on it for 8 months now.
Also, she has asked me to start taking fluconazole in the hopes that it will help my finger and toe nails. To be honest I am so over having nail psoriasis. I've had it since I was 15. My nails are often so brittle. They break easily when I bang them and often lift from the nail bed if I knock them.

We also discussed what comes next if I the mtx isn't working as well as we hope or if things take a turn for the worse. I would need to either try cyclosporin and/or acitretin for a while. In the event these don't work I will be able to go on to biologics. I'm not too sure about using a biologic as they are usually injections and the thought of giving myself an injection is not the most pleasant of thoughts; but that may not happen for quite some time and who knows by then I may have talked myself in to it.

For now I have been asked to research cyclosporin and acitretin. Both medications have side effects that I don't like the sound of. Some sound pretty nasty. I guess it is something I need to think a great deal about before deciding if it is the right thing for me.

Cross your fingers that this increase in mtx will help and continue to work well and that my blood test results will come back fine.
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