PSORIASIS

My age is 45 years.I have been suffering from psoriasis for last 25 years .In last 5 years it has become a big headache for me.Now i have been diagnosed with psoriatic arthritis for last 3 years.To check it, my doctor gave me methorexate+indomethacin 6 months back.It gave me instant relief .my patches of psoriasis completely disappeared.I was having  extreme pain & stiffness in neck region ,shoulders & rib cage.I also got rid of it.I was advised to get my SGOT & SGPT level monitored regularly.When these levels reached around 60,i was advised by my derma Dr to stop medicine.By that time i had taken methotrexate 7.5 mg per week for three months.now my body is again getting stiff & patches of psoriasis have again come out & in much more severe shape.I have again been advised to start using methotrexate & for a quiet longer period say 2 to 3 years. As regarding SGOT/SGPT level,DR says that even if it reaches 2 to 3 times upper limit (between 100 & 120)there is no need to worry.
I am strict vegetarian,does not smoke or drink.my query is:

1.Should i take methotrexate for such long time with SGOT/SGPT going on increasing.
2.Would these high levels not damage my lever.
3.what precautions i need to take during course of medication.
4.Is there no permanent solution to this problem.
5.For relief from pain & stiffness,which medicine(safest) should be taken .

Please guide me

Thanks & Regards

  Sanjay

[Bhupinder Kaur, MD]

Hello,

Psoriasis is an autoimmune disease which presents as red, scaly patches appearing on the skin. For mild disease topical (skin applied) creams, lotions, and sprays like coal tar, dithranol (anthralin), corticosteroids like desoximetasone (Topicort), fluocinonide, vitamin D3 analogues (for example, calcipotriol), and retinoids may be very effective and safe to use. For severe disease, it may require systemic or total body treatments such as pills, light treatments, or injections like methotrexate, cyclosporine, fluoruracil and retinoids. Then phototherapy can also be used.

SGOT and SGPT enzymes should not increase so much as it may be not good for the liver. Instead of methtrexate you can resort to other mentioned treatment options. Phototherapy is another good option for treatment. Please discuss the same with your doctor.