In difficult situations a consultation with a university clinic
Dermatology group is worth the effort. Disease modifying
injectables such as Humira or the new JAK inhibitor drugs
can be prescribed off label. There are also some new topicals that can help.
They are costly but the new limited copay for Medicare is
$ 2000 yearly. I have taken advantage of the monthly
payment program of 181 dollars to spread out the cost for Humira.