Factors that can trigger psoriasis: UV light, stress , infections, drugs ( anti TNF, Immune Checkpoint Inhibitors, beta blockers). In case of unexplained flare up look for an underlying cancer or HIV infection. ( for more details see www.rheumnow.com)

Covid 19

With the current evidence , it seems the rheumatological patients  have neither an increased risk of contracting SARS-Covid 19 infection  , nor are they further protected against it. Follow the Public Health recommendation meticulously.  

The following website provides  useful information:




Methotrexate at the doses used in rheumatology, i.e. less than 25 mg weekly, is an immune modulator. Statistically , RA patients treated with methotrexate have less risk of developing diabetes mellitus, infections, cancer and cardiovascular complications. 8000 IU of vitamin A can help with the oral ulcers and nausea  associated with methotrexate.

Two doses of Dextromethorphan ( 20-50 mg ) at the time of taking methotrexate and 8-12 hours later, may help with the fatigue following methotrexate.  The following is a resourceful website to find useful information on methotrexate and related subjects :