Methrotrexate and arthritic psoriasis

1 Posted Tue 19 Mar 2019 11.42 by Nickir

I was diagnosed with arthritic psoriasis by a rheumatologist 12 mths ago. Last October my psoriasis flared up very badly ( the loss of my father brought it on I think ). I was referred to a dermatologist who is looking to prescribe a drug called Methotrexate. I believe this is a very very low form of chemotherapy which suppresses your immune system. He has told me it is very successful in treating both my arthritis and psoriasis. However reading up on it there can be a few side effects and you can be prone to illness as the immune system is low. Has anyone had any experience of this drug.... good and bad please. I have my follow up appointment with the dermatologist on Friday 22nd March and am expecting him to be writing the prescription. thanks in advance Nicki

Posted Tue 19 Mar 2019 11.54 by mazza

Hello there Hope you don't mind me poking my nose in. Sadly this isn't an answer to your question but, like yourself I am due to go on it myself early next month. I too have read comments online and some of those were quite scary. Hopefully someone can put both of our minds at rest in one go. Good luck for the future. Thanks, Mazza

Posted Tue 19 Mar 2019 12.17 by Nickir (edited Tue 19 Mar 2019 12.17 by Nickir)

Hi Mazza, absolutely not. we can both hopefully get some answers from people who may have had the drug. Like you I was rather scared of some of the comments. However I am airing towards the tablet as both my arthritis and psoriasis is at its worst and I need to try something completely different. I am on a waiting list for a long term steroid in my back but am told its still 6 mths away. lets hope we get some good feedback and good luck too.

Posted Tue 19 Mar 2019 12.59 by Suzie
I have suffered for around 7 years and have it covering my back and front.

Hi, I've been on MXT for about 5 years now and i'm lucky not to have experienced any side affects although i know there are people that have. Its worth a try though, if it doesn't work for you then you can stop. Good luck to both of you.x

Posted Tue 19 Mar 2019 13.14 by mazza

Thanks Suzie Has the drug cleared it up completely. I shan't be to graphic about where I have it but, lets just say some days I walk like John Wayne !!! Mazza.

Posted Tue 19 Mar 2019 13.27 by Suzie
I have suffered for around 7 years and have it covering my back and front.

Hi Mazza, haha the wonderful places it turns up eh! So my Derm first put me on cyclosporine first as a quick fix which cleared it up within weeks then i changed to MXT after about 6 months and it stayed clear. I do get the odd bit on my scalp and around my ears from time to time but apart from that it works well for me. I'm not sure how long it will take to clear as i was on the cyclosporine first so maybe someone else will be able to answer that. x

Posted Tue 19 Mar 2019 13.28 by mazza

Thanks Suzie. Best wishes.

Posted Tue 19 Mar 2019 14.19 by Johnboy_66

Hi all I'm new to methotrexate myself but to the person who is thinking about tablets I was on them for a couple of weeks and had a few of the nasty side effects I'm now on the pen injections had two doses and no real side effects to mention so I think that I will stay on injections hope this is helpfull to some of you.

Posted Tue 19 Mar 2019 17.14 by Waffs

Hi Nicki, I have been on Methotrexate tablets for 20 months. I take 15mg once a week and 5mg of Folic acid tablets three times a week. For me, the methotrexate has worked wonders as I am virtually free of the psoriasis that has plagued me for 30 years. I too had it in my groin, my scalp, legs and feet as well as on my back. and I had a major flare up two years ago which was so bad that I was having to crawl every where as my hands and feet were covered in plagues that were extremely painful. I also have psoriatic arthritis and the methotrexate has helped with that but I still get pain all over the place. For me it helped and the folic acid helped with the side effects. I hope this eases your mind a bit. Good luck for the future whatever you decide.

Posted Wed 20 Mar 2019 11.53 by Nickir

thank you all for your feedback. looking forward to my consultant meeting on Friday to move this on further. Nicki

Posted Mon 25 Mar 2019 08.45 by Gravy9499

I have been on methotrexate for many years for my skin it took a short while to find the right dose that worked for me the only way I did not get any side effects was to increase my fitness level by doing that I've had no side effects for over a year I think it's very important to change your diet and your health and the way that you live for not only give your psoriasis a better chance but also to give your body a better chance accepting the drug the drug is a very strong drug they should be taken with caution but it's also very effective drug treating psoriasis hope this helps you all the best with your skin

Posted Tue 26 Mar 2019 00.56 by Tahoedude (edited Tue 26 Mar 2019 00.58 by Tahoedude)

Hi Nickir, I had pretty severe psoriasis that was on my elbows, ankles and thighs. After treatments with narrow band lights to keep it under control I decided to see a dermatologist recommended by a friend. The dermatologist put me on Methotrexate (six pills a week) and followed up in 45 days. When I returned to see the dermatologist she said we could do better and upped the dose to seven pills a week. She checked my blood work and said I was handling the medication well. The psoriasis cleared up well and had no issues. I was a little concerned as this drug does lower the ability of your immune system to fight infections. After about five months of usage, I developed a dry cough that would not go away, especially at night. I had to go off the medication and my psoriasis came back. Upon returning to my dermatologist, she then put me on Acitretin, another psoriasis medication. This was the last oral medication I could take before going on injections. My medical insurance is not great and injections are very expensive. She recommended I take two pills per day which I began with one pill as the side effects are dry skin, chapped lips, weak nails dry nails, and overall dryness in the nose. Additionally, the pills are fairly expensive. Initially I had no luck with the psoriasis and my big toe toenail split causing an ingrown toenail. I lived with it for about a month as I thought it may heal itself, but it did not. The toe area became very red and infected and then my psoriasis got very bad (I believe the psoriasis flared up as my body was reacting to the infection). I decided to have the ingrown nail addressed and upped the medication to two pills. The toe healed and the medication is making my skin very dry with chapped lips and a very itchy back. After two weeks I am seeing improvement with the psoriasis but I'm not too crazy about the itchiness. I will keep you posted. From what I've read and heard, Acitretin is a safer medication to take than Methotrexate as it doesn't lower your immune system for infections. I am just trying to adjust to the dryness. I'll keep you posted.

Posted Thu 28 Mar 2019 18.06 by Gazza

Ok, so I have been taking Methotrexate for 20 years or so. I currently am on 7 x 2.5mg tablets per week and 1 Folic Acid tablet a week. I have a blood test every 2 months. I also use Alphosyl 2in1 Shampoo regularly. The psoriatric arthritis seems ok but matters are slightly complicated because I also have rheumatoid arthritis. Not that this a big deal as I use 10% Ibruprofen concentrate on those joints as and when necessary. Insofar as Methotrexate is concerned have to say the skin cleared up after I increased from 6 to 7 tablets a week, so being clever I stopped taking them. After a while it returned and I went back on them. The situation now is that the patches have stabilised but do not bother me to the extent that I want to increase the dose. The Alphosyl 2in1 shampoo works well (I have tried others over the years) but I am now looking to try perhaps a coal tar emollient in my bath just to try to get the patches on the skin to disappear. Not sure all this is very helpful but as a long term Methotrexate user the drug has not bothered me too much. Perhaps I am just lucky.

Posted Sun 7 Apr 2019 12.29 by Headshoulderskneesandtoes

I am surprised that a dermatologist is prescribing methotrexate and diagnosing psa. It was my thinking that it is a rheumatologist who diagnoses psa and prescribes methotrexate etc.. that is what my dermatologist told me 2nd April 2019 and has reiterated to my gp the need for me to see a rheumatologist. Please can the people who are replying to this confirm dermatologist is diagnosing psa and prescribing methotrexate and if possible where about in the U.K. they are doesn’t need to be full postcode etc.. I am in Worcestershire area for treatment.

Posted Mon 8 Apr 2019 14.42 by Nickir

Hi there as per my original thread it was my rheumatologist who diagnosed psa not my dermatologist. As I am seeing both consultants on a regular basis both are aware of each others options. I have done quite a bit of research and more often than not its the dermatologist who prescribes methotrexate and appears so in the threads of this message . I would question that either could prescribe due to the nature of the drug and how works. I am in the Warwickshire area. good luck

Posted Mon 8 Apr 2019 15.46 by Headshoulderskneesandtoes

It is probably that a gp or dermatologist can prescribe after a rheumatologist has diagnosed and first prescribed. It wasn’t your post as it is clear your rheumatologist first diagnosed and prescribed, it was other commenters who said there dermatologist had done so and I just wanted confirmed in what order. I went to another gp today 6 days after my dermatologist and he wasn’t happy about the length of time I am waiting for a rheumatologist and said he couldn’t prescribe methotrexate but would if he could. He gave me naproxen.

Posted Mon 8 Apr 2019 16.28 by Headshoulderskneesandtoes (edited Mon 8 Apr 2019 16.28 by Headshoulderskneesandtoes)

Ok think I have worked it out using google. Dermatologist will/can prescribe methotrexate if psoriasis is really bad and not responding to creams lotions etc... My dermatologist and gp was reluctant because I have not had my psa diagnosis by a rheumatologist yet.

Posted Mon 8 Apr 2019 16.33 by Suzie
I have suffered for around 7 years and have it covering my back and front.

My dermatologist prescribed my methotrexate, I’m in Kent x

Posted Mon 8 Apr 2019 16.49 by Headshoulderskneesandtoes

I have it on my scalp,chest,groin,legs,fingernails, toenails.

Posted Wed 10 Apr 2019 17.44 by WorkingMumOf3

Hi, I’ve had PSA for 2 years and Nail Psoriasis for over 30 years. My rheumatologist prescribed Methotrexate for PSA in my hands. I had the usual nausea for 24 hours after taking it. But at week 4 I noticed my hair was falling out. I persevered until week 7 when I couldn’t cope with it anymore as my hairline was rapidly receding and my whole head of hair was thinning. It stopped falling out within a couple of weeks of stopping the treatment and started to grow back after a couple of months although my hair is not as thick or full anymore 18 months later. Also, what grew back was white, I am 47 years old so have aged prematurely,. Three months after stopping it, I had a huge flare which lasted 4 months. I’ve since tried sulphasalazine and apremilast to no avail. PSa has now spread to my feet. Rheumatologist wants me to try Leflunomide now but as it too is linked to hair loss, I have asked for an alternative. Methotrexate works for many people, but not for me. Good luck in whatever you decide.

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