While some of your long-term rheumatoid arthritis medications, like sulfasalazine (Saaz DS) or methotrexate (Folitrax-15), can occasionally cause skin reactions, it is less common for them to suddenly trigger breakouts after ten years of stable use. These breakouts on your chest, back, and shoulders are very common in young men and are often typical truncal acne or folliculitis. Please do not stop your vital arthritis medications. I highly recommend consulting a dermatologist who can safely evaluate your skin and provide targeted treatments, while working closely with your rheumatologist.

Psoriatic arthritis is a chronic condition, and currently, there is no complete cure. However, it can be effectively managed with long-term treatment to control skin symptoms, reduce joint pain, and prevent further joint damage. Doctors may recommend medications, lifestyle changes, physiotherapy, and regular monitoring to keep the condition under control. With proper treatment and care, many people are able to live a comfortable and active life despite the condition.

Yes, her symptoms of severe stomach pain, vomiting, and white stools can point to a liver or bile duct issue, which can sometimes be linked to medications like Folitrax (methotrexate) or Wysolone (prednisolone). White stools suggest bile is not reaching her intestines properly. Please take her to the nearest hospital or consult her doctor immediately for a physical exam and liver function tests. It is best to hold her medication doses until a doctor evaluates her.

Since you still have active symptoms, the next steps typically involve discussing adjustments with your rheumatologist. Options may include safely optimizing your methotrexate dose, adding another medication like sulfasalazine, or transitioning to targeted therapies like biologics. Please schedule an appointment with your specialist to explore these options.

Palmoplantar psoriasis can be challenging, but please don't lose hope?there are other effective options. Since methotrexate (Folitrax) hasn't helped, it is best to consult your dermatologist about alternative treatments. They may suggest switching to other oral medications like acitretin or cyclosporine, trying targeted phototherapy, or advancing to highly effective modern treatments called biologics. In the meantime, keeping your hands well-moisturized and using prescribed strong topical ointments can provide some relief.

Your normal ESR of 10 is very reassuring, showing that systemic inflammation is well-controlled. This stiffness doesn't necessarily mean your medications have stopped working; it could be caused by localized joint inflammation not fully reflected in blood tests, daily mechanical strain, or weather changes. I recommend discussing this with your rheumatologist, who can evaluate your joints and safely adjust your treatment plan or suggest supportive therapies to help you feel more comfortable.