I am on Otezla 2x day . I have several autommune diseases and also psoriasic arthritis. It has been a God send I had it on my feet and hands. I could hardly walk because it was so bad. My hands and feet would bleed so bad I would have to wrap them and bleed through. I weighted out the possible side effects to how desperate I was for relief. So I would do my research and weigh out the possible side effects. Good luck.