You might want to ask your doctor/dermatologist to try you on Methotrexate. Your liver enzymes will have to be under observation during this treatment.You may not be able to stay on it long term if titrating down the dosage does not work. Titrating down from full dose of eight 2.5mg pills once a week didn’t work in my case, but because of my history of fatty liver disease my dermatologist didn’t want me to continue at the full dose after three or four years. Stelara injections don’t seem to be working, but the nurse told me it takes some months to see results (it took six months with Methotrexate).

Unfortunately my dermatologist has retired and has transferred me to another dermatologist but because of the Covid lockdown situation in Toronto there is a backlog of appointments with the new dermatologist so I am still waiting to see him.