severe atopic eczema - methotrexate treatment

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telboy2000
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by telboy2000 on Thu Nov 19, 2020 2:49 pm

severe atopic eczema - methotrexate treatment

My 3.5 yr old has severe atopic eczema for which topical steroids are not working so we have be told that the next step are immunosuppressants like methotrexate. We did some research and we are worried about the long terms use and possible side effects etc. Does anyone know of any other immunosuppressant out there that may have less harmful side effects.

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Dr Adil Sheraz
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by Dr Adil Sheraz on Fri Nov 20, 2020 11:57 am

Re: severe atopic eczema - methotrexate treatment

Thank you for your question.

I'm sorry to hear that you child is suffering to a degree that they need an immune suppressant.

Immune-suppressants are treatments that area regularly used by dermatologists to help with multiple skin conditions including eczema and psoriasis.

When reading about Methotrexate it can seem very frightening particularly when it is for a 3.5 year old.

However Methotrexate has been around for a very long time, the mechanism of its action, its immediate and long term (potential) side effects are very well understood and have been thoroughly researched. It is also used once weekly which can sometime be easier than daily tablets. Therefore it is often a treatment we use to control eczema.

Other treatments that we may consider include Azathioprine (also often used in children).

Ciclosporin is also occasionally used in shorter bursts ( a few months) to control severe eczema.

Phototherapy is also an option, however standing in a UVB booth may not be appropriate for for 3.5 year old.

However your child's case would of course be better understood by your regular dermatologist, and there may well be reasons why he/she cannot have certain immune suppressants. There are various blood tests that are performed prior to starting immune suppressants, these help us make a decision as to which one will be safest. If immune suppressants are monitored appropriately then they can be very effective relatively safe treatments. Your child's and also your quality of life could become significantly less stressful and improve.

I hope this helps. I wish your child the best of health. Hopefully as they get older the eczema may settle.

Dr Adil Sheraz
Insta: Dr_Adilsheraz
Dr Adil Sheraz
Consultant Dermatologist - MBBS, BMEDSCI(HONS), MRCP (UK), MRCP (DERMATOLOGY) (UK)

http://www.talkhealthpartnership.com/on ... sheraz.php

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