Conversation: The conversation between human and AI assistant.
[|Human|] i am suffering from psoriasis since 10 years.now it become very dangerous. it cover almost all part in my body. i take 15 mg MTX in every week.I also took PUVA.but nothing can control my psoriasis.I am 25 years old and iam married woman. my mother in law, my husband always torture me mentally. i have no child. my husband now wants a baby. i am an electrical engineer from KUET. but i cant join any job for my illness.so i am financially in secure. i am very helpless. what can i do?
[|AI|]  Hello. Thanks for writing to us at Chat Doctor I feel very sorry for all that you have been going through for no fault of yours. I must assure you that there are a host of treatment options that effectively clear psoriasis and most people with psoriasis are able to lead a normal life and can extend there families just like others. Though Methotrexate is a well known and tried and tested treatment option for generalized disease, lack of responsiveness to Methotrexate may be due to reduced oral bio-availability/decreased Oral absorption. An alternative is to switch to injectable Methotrexate i.e. either I'm Or I/V. Cyclosporin is another option that may be tried in your case; it is an immunosuppressive and usually brings about remarkable improvement even in the most widespread skin involvement with psoriasisOral retinoids are also effective options for generalized plaques psoriasis and can be either used alone or combined with other systemic treatment options like Phototherapy. A word of caution for retinoids is that they can cause fetal defects in pregnant ladies. The recommendation is that females treated with Retinoids should not become pregnant for at least 2 years after completing treatment. Topical treatment is an adjuvant to oral treatment and comprises topical emollients, steroids and vitamin D analogues.Finally, Biologics are the newest category of Chat Doctor.  The negative aspect of biologics is that they are expensive. I would suggest that you seek another appointment with a dermatologist in your region for assessment of the severity of your psoriasis and most appropriate treatment for you. Regards