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Methotrexate Rebound ... Kukui Nut Oil
from Venny V.

Hello Ed!  Came across your website by chance and I enjoy it immensely!  I've been one of those who've gotten off scot-free from psoriasis for more than 7 years, thanks to methotrexate (MTX).  Two liver biopsies later, I continued taking MTX until recently, my derm told me my blood platelets count has gone down. 

Her advice is that I start to wean off MTX and go back to PUVA.  Meanwhile, my psoriasis has returned with a vengeance, something I haven't experienced in a long time.  Because my platelets count continues to go down, recently my doctor told me to get a liver and spleen scan (don't have results yet), and in another week, I'm scheduled for a bone marrow biopsy, to see whether I am producing enough platelets and where they’re going, or if I'm not producing enough.

Meanwhile, in my panic I went along with the Solanus program recommended by a friend which cost me an enormous amount, $545 for the regimen plus $100 "donation" for the salesman's advice (he asked for it), PLUS another $300 for an aerobic exerciser for the legs.  This was before I surfed the NET.  Had I looked into the NET first, I definitely would not have gone to him.  But when desperation overcomes you, it's like there's no choice BUT.  Since I have the products I'm trying to just make the most of it.

But your site has already given me a lot of wonderful advice and insights, and I'm eager to try them, especially coming from testimonials from people who've been cleared. 

I am surprised that no one in your site has mentioned KUKUI NUT OIL, a local product which apparently does wonders to P.  I tried it last night, bought me a 4 oz. bottle, spread the oil on my body (my P is all over) and did the Saran wrap like I would with clobetasol.  The next morning, the lesions are no longer thick, they've all thinnned out and my skin feels great!  You might have your readers check into it. The website I saw it on also has testimonials from people who've been cleared of P using kukui nut oil (Oils of Aloha). 

I do have questions for you Ed: 

1) Are cereals, seafood (squid, crabs, shrimps, mussels) no good?

2) Should I continue taking PUVA which to date, has I think, worsened my psoriasis?

3) What bath solutions do you recommend?

Thank you Ed, and I look forward to hearing from you. Sincerely, -Venny V.

*****

Ed’s Response:  Sorry to hear about the need for you to stop MTX.  I’ve been there; however, I made a “dissolve” transition from MTX to cyclosporine — that is, I stepped down my dosage of MTX at the same time I was building up to my proper dosage of cyclosporine — in an attempt to avoid the inevitable flare up.  And, first time round, it worked.  Not only did I not flare, once I was seated on the right dosage of cyclo (which took time because I fudged on my true weight and cyclo doses are weight-based) there was more improvement than I had achieved on MTX.  For many months I, too, was lesion-free.  What a feeling, after a decade of severe flaking! 

I’m not surprised about your severe rebound shifting from MTX to PUVA.  On the other hand, given your blood work mystery, I can also appreciate your derm’s reluctance to migrate you over to another systemic.  It sounds to me like you might be an ideal candidate for the combo Amevive/UVA therapy when (ever!?) Amevive gets to market.  Have you discussed this possibility with your derm?  (For more information, search here for “Amevive,” search at the National Psoriasis Foundation site, and visit Biogen’s page about the product.)

I looked on the web for your “Solanus” program and found nothing.  I would ask you for more information — but if it’s not helping I don’t suppose we need to know more. 

Regarding Kukui Nut oil.  It has been mentioned here:  Considering Dermarest Products[0101h.htm] — exactly two years ago.  But now, thanks to you and Linda A., I’ve found the site you inferred — Oils of Aloha — and am glad you brought it to our attention.  What makes this promotional page shine where so many others don’t?  They start their pitch with a forthright admission that they don’t cure P.  And they end their pitch by repeating that admission.  I’m tempted to buy a bottle of the oil just because I respect their product promotion!  Thanks for the tip, Venny (and Linda).

Now, to your questions.

1) Are cereals, seafood (squid, crabs, shrimps, mussels) no good?  I’ve only had one doctor, a Chinese Doctor of Acupuncture, tell me not to eat shrimp — and that was the only item from your list this doc said was prohibited.  (For story, click here.)  I suppose you will find diets claiming to help P that will preclude some or all of these foods; but I’m not a follower of this approach to P management.  You may want to read Dave W.’s thoughts on P diets, or search on "diets" here for an afternoon's worth of reading on and around the topic.

2) Should I continue taking PUVA which to date, has I think, worsened my psoriasis? I’m totally unqualified to answer this question but I will make an observation.  Your worsening P may be attributable to rebound from the MTX.  The strength of that rebound may just completely drown the palliative benefits of the PUVA and it may take awhile for your system to “erase” the effects of MTX and quit its temper-tantrum about its removal. (It helps me to think of these rebound phenomenon as drug withdrawals.)  Talk to your derm about how long you should continue PUVA before it’s obvious your situation has gone beyond any MTX rebound effect.

3) What bath solutions do you recommend? I don’t recommend any simply because I have no personal experience.  Search on “bath” here and you’ll be directed to over 50 references from the archives.  In some of them products are mentioned by name and there may even be links to product web sites.  If you find a bath solution that works well for you, please do let us know.

Good luck.  -Ed

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