Monday, March 24, 2008

Methotrexate

Psoriasis can be defined by the American Heritage Dictionary as “ a skin disease marked by recurring inflammation and scaly patches” (p 677.) This disease affects every race, men, women, children and even the elderly. Even though psoriasis affects everyone it is thought that it affects Caucasians more than any other race. This skin disorder will affect that person for the rest of his or her life. There since has yet to be a cure for this skin disease. Many patients who get psoriasis may also get arthritis.
Psoriasis is an inflammatory disease which certain immune cells become over active (www.sicus.sirus.com) To probably diagnose the disorder a dermatologist may need to take a skin biopsy (www.sicus.sirus.com) . Psoriasis affects two to three percent of the population in America (pg 9 100 questions and answers about psoriasis.) Some things that can trigger psoriasis to become inflamed or get worse is stress, injury to skin, certain medicine, allergies, diet, and weather (National Psoriasis Foundation.) Some patients may say that warm weather may help them. Cold weather affects the psoriasis because it can make it chapped and dry out your skin. When a person skin gets worse a lot of patients may become depressed. They may not want to leave their house because of the staring and this may cause them to get into a deeper depression.
Methotrexate was first used in 1958 (P. 238 Camisa.) Like most drugs you need to evaluate your values. Some of the values may be cost, side affects, how do I take it?, is there any danger in taking it while I’m pregnant. This drug is used to suppress the immune system. It can be taken orally or injected into the skin. Like any other medication you may experience some side affects like nausea, fatigue, etc (P. 238 Camisa.) Methotrexate may be the cheapest drug out on the market, if you do not have health insurance. The cost of the drug is around $50 dollars. Since the drug affects your liver you will need to get your blood drawn. This can be as high as $75 dollars.
Some may argue that Methotrexate should not be taken. Patients who take this drug have to get a liver biopsy because Methotrexate may cause liver disease. Also, you cant’ take any anti-inflammatory aspirins because it will cause toxicity (p. 67 Lowe.) People who drink should not take this medication since; alcohol is generally associated with liver disease. Since the drug generally affects the liver, doctors will need to monitor your liver by doing a liver biopsy (Long, Kerhole, etc.) When the patient decides he or she does not want to take the drug anymore, their psoriasis may become worse. Women/Men should not take this medication if they are trying to conceive a child. This should stop taking it for at least three months.
I have taken Methotrexate on and off for the past two years. It has significantly helped me in many ways. Not only did it help me with my skin but it has helped me with my self confidence. People do not stare at my skin. I do not have a problem with people asking about my skin but it does get tiring after a while. Even though I have many options for other drugs, this one is the cheapest. I had been told by my doctor that Embrel and other drugs may be as expensive as $1500 a month. One draw back I do not like is that I have to get blood test almost every month.

































Worked Cited
Chamisa, Charles “Handbook of Psoriasis” Blackwell Publishing Florida 2004 3/5/08
Lowe, Nicholas J. “Psoriasis; A patient’s guide.” Thonson publishing services New York 2003 3/5/08

Gelfraud JM, Feldmen Jr, Stern Es, etc “Determents of quality of life in patients with psoriasis.” J am Acad Dermatol 2004 New York 3/5/08

Kendra Gail Bergstrom, MD and Alexa Boer Kimball, MD, MPH. 100 Questions & Answers About Psoriasis. Sudbury, MA: Jones and Bartlett, 2005

“New ways to treat psoriasis” Http://sks.sirs.com/cgi-bin/hst-article-display?id=SAZO315-0-8950&artno=0000164026&ty. 2003 3/5/08


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