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I poked around a little in Google and it appears that acne can be a side effect of methotrexate.  I would suggest you speak to your rheumatologist about this - you may want to discuss removing methotrexate from your cocktail for a while to see if that helps.   In terms of the rash - when I was on Enbrel, I got a lot of rashes. The medication seemed to significantly increase my histamine response and I got terribly sensitive, developing rashes whenever my clothes were rubbing against my skin. I continued with the medication, though, because the benefits outweighed the rash. Ultimately, I ended up switching to Humira because Enbrel was giving me bad muscle spasms (I also have fibromyalgia and Enbrel aggravated that) and the rash disappeared. I still have a few areas with a rash, but nothing like on Enbrel. Did your rash come back when you start using the cream?