Phototherapy, Ciclosporin or Methotrexate?

There is a newer treatment over metho or ciclo and that is Otezla (apremilast). http://www.mims.co.uk/otezla-new-treatment-psoriasis-psoriatic-arthritis/dermatology/article/1333618 Also light treatment hardware can be purchased or hired if within your budget. I am saving up for a 8 x 4ft tube array but unfortunately my pot keeps getting raided for bill paying, but I'll get there one day :wink:

I just bought a small light pad by phillips. It seems to stop the flakeyness. I paid approx £200.

I have a full size walk in cabin made by Dr. Honle. Germany. Due to my relocation I have had to store it in the U.K.. (Leicester.) I live in the B78 Area Midlands. Its in perfect working condition with ten spare tubes. My idea was to relocate it and use it within a small amount of members inc. myself. I have had the experience of using it and still have the instruction books etc. I am overseas at present, but willing to discuss practical ideas to use this superb unit again But it needs a new location where its practical for all concerned to use. John C.

I tried all of these in 2012, when I was covered from neck to ankles in plaque psoriasis: Methotrexate had a few minor side effects (e.g. nausea) in the first couple of weeks, and after around 6 months of treatment it had no effect on my psoriasis. I seem to remember having blood tests every month or so. I then switched to Ciclosporin. Ciclosporin had no side effects and cleared the psoriasis from my arms, legs and lower back, and to a limited extent reduced the intensity of psoriasis elsewhere within four weeks of being put on the highest dose. I was on ciclosporin for around 6 months. Again, I seem to remember having blood tests every month or so. I then switched to UVB phototherapy. UVB phototherapy cleared my psoriasis completely after 10 weeks (three sessions per week). I was lucky in that I lived within 30 minutes of the hospital, which was in turn within 20 minutes of work, and they opened at 7.30am, so I easily got to work by 9am. I remained largely clear for the next four years, with a very small number of patches returning over time, but these were controlled very easily with Dovobet. Unfortunately in June 2017, my psoriasis rapidly spread and I'm back where I started in 2012, although it's much more sore, itchy and painful than it was then... I tried a couple of weeks of UVB phototherapy again, but this made my psoriasis feel like it was burning and much more sore. My consultant stopped and has referred me for biologics, but the appointment isn't until the end of Jan 2018. Whilst I wait, I'm on the maximum dose of ciclosporin again (albeit privately at the eye-watering cost of £326 per month) which will hopefully have a similar but limited effect as in 2012. I hope that you get quick and painless results with whatever you decide!

Can you get the cyclosporin on NHS or doesn"t the doctor recomend it?

Richysorefoot: I begged my NHS consultant to give me a systemic (e.g. Ciclosporin) to use during the three month wait until my biologics appointment, to ease the psoriasis. The response was that I need to "pick one or the other", i.e. pick a systemic now which will have limited effect based on my previous experience (and forget about biologics), or pick a biologic in three months' time (and forget about any treatment in the meantime). Of course, I stuck with biologics, knowing that systemics (e.g. Ciclosporin) have only cleared around 50% of my psoriasis previously. It was a bit of a devastating day really, as by that point I'd already been working from home for around six weeks, to the dismay of my HR department, due to the soreness, itchiness and sleep deprivation. It's so bad now that I'll be on sick leave for at least the next month. So it was a case of existing in a largely painful and sleep deprived state, housebound and on sick leave (until the inevitability of unemployment) until the end of January, or getting some private treatment to somewhat reduce the suffering whilst I wait, which in turn may provide the possibility to return to work, not lose my job and restore some aspects of normal life.