Would oral roflumilast be a reasonable and tolerable option for severe psoriasis in an elderly patient with a history of pulmonary aspergillosis who has failed other systemic therapies?  

This patient has severe psoriasis vulgaris, failed phototherapy and Ilumya, and previously responded to Skyrizi (no longer covered under her medical benefit). She also has pulmonary aspergillosis requiring antifungal treatment while on biologic therapy, mild COPD, and weighs 95 lbs. She does not have Medicare Part D. Her daughter asked about Otezla, but I was considering oral roflumilast instead. How well is it tolerated in an elderly, low-weight patient, what dose would you recommend, and how quickly might it work?