### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
i am suffering from plaque psoriasis from 15 years.i am using folitrax from 3 yrs.till now i have used 640 mg of folitrax.how much folitrax to be taken in our lifespan.my age 25.weight 64kg.in between i have used acetrin 50mg for 2 months.till now it is not cured.is there any other treament.biologics are cost effective.wat z the diet to be followed.i am a veg purely.recently my total cholestrol level z low92mg/dl.HDL z 28mg/dl.LDL Z 40mg/dl

### output:

Hello. Thank you for writing to us at Chat Doctor Psoriasis is a chronic skin condition. The patches in psoriasis are red, scaly and distributed at various body sites, predominantly extensor skin surfaces like elbows, knee and scalp. The disease has a remitting and relapsing course i.e. it may re-occur after a seemingly complete cure. Methotrexate is very effective in treating psoriasis patches. Though it is a common Chat Doctor. A liver biopsy is recommended after reaching a total cumulative dose of 1.5 grams of methotrexate, to look for any early/developing fibrotic changes in Liver. In an effort to reduce the total cumulative dose, Methotrexate can be either combined with other treatment modalities like Phototherapy, Accretion, topical modalities Or it can be alternated with other Immunosuppressive like Cyclosporin. Since you have been taking Methotrexate for 3 years now, amounting to a total cumulative dose of 640 mg, therefore, my approach in you would be to use Methotrexate judiciously i.e. either alternated with other Immunosuppressive like Cyclosporin Or combined with Phototherapy and topical treatment modalities. Biologics are newer entrants in the treatment of psoriasis. They specifically target the immune mechanisms involved in the pathogenesis of psoriasis. They are expensive but also produce long-lasting remissions. I suggest you to discuss these points in more details with your treating dermatologist. Regards