Methotrexate Had Been His Safety Net
from Adrian A.

Flaking is an understatement for what I am going through right now. My palms, arms, elbows, chest, neck, head, feet, groin and even my face have been affected by this latest attack and I feel as though I should be hiding away somewhere so that nobody would be able to see me. But I can't.

I have had P for the last ten years, since I was 18 to be exact, and during that time I have used so many creams and ointments that I don't even know what is left to be tried. The only thing that used to make it go away was Methotrexate, so there was always a fall back, in my mind I knew that there was something, in spite of any side effects, that would make the scourge of my life go away for a period of time. And so during this time I have gone on with my life, paying as little attention as I possibly could to my condition.  Not thinking about it seemed to keep it controlled and limited to my elbows. Whenever it flared up I used Methotrexate and after a few weeks it would subside.

My latest bout could not be treated with Methotrexate, so I am on my fourth day of Neotigason [acitretin, sold in the U.S. as Soriatane –Ed], now I have no fall back, my safety net has been removed.

In my case P has had a great effect on everything I do, my job is Food & Beverage Manager in a hotel resort, so I am surrounded by people in a food environment and flaking does not always inspire confidence.  Despite the funny looks and of course the questions I refuse to let this condition rule my life.

You see I am exactly where I wanted to be with my life at the moment, I have a great wife and a beautiful baby daughter, my career is going places, and no way am I going to let either the pain I have in my hands or the flaking all over change things.  

Psoriasis is a condition and, from all I read, doctors don't seem to be any closer to a remedy then they are on AIDS, so all we can do is accept that we have to live with it, yet we have to go on and live.

Admittedly, I do look forward to a day when I pick up a newspaper and read that there is a cure but I can't hold my breath, life is too short.  –Adrian A.

*****

Ed’s Response:  No, we can’t hold our breaths, Adrian. 

Hopefully your doctor prepared you for a bit of a set back as you move onto Neotigason.  Some people experience rather unpleasant side effects at the onset of acitretin therapy (see Soriatane Side Effects Too Awful to Tolerate and Soriatane after Cyclosporine in this month’s mail).  If you get through these side effects okay, hopefully you’ll find the drug a useful replacement for methotrexate.

Also, keep you eyes out for the release of more biologic drug therapies.  I’m uncertain as to where you live, which means I’m also uncertain how available any of these new drugs may be to you.  For some people these are working marvelously.  Their promise is fewer side effects and less toxicity over time.  In the U.S. the price tag is high. 

Good luck and keep us informed, Adrian.  -Ed

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