Each of the above-mentioned treatment methods is selected by the doctor individually for the patient. The choice of one of the ways is dictated by, among other things, his state of health, the medications he is taking on a regular basis, or the likely cause of the problems. The decision is made on the basis of a thorough history, blood test results, histopathology or trichoscopy.
In the case of PUVA treatment, contraindications to its use may include, for example, pregnancy and lactation, the patient’s too young age, kidney and liver damage or certain ophthalmic diseases. It is also not used for people who have undergone cancer in the past or have an increased risk of developing oncological diseases. The use of photosensitizers other than those administered during treatment or general hypersensitivity to UV radiation may also be contraindications to light therapy.
Glucocorticosteroids are not given to people who suffer from large and unregulated blood pressure disorders, osteoporosis or advanced ophthalmic problems, but this depends on the specific case, as well as the drug used. In contrast, immunotherapy is mostly not used to treat children under 5. year, unless very well justified. It is also contraindicated by HIV infection or the presence of other conditions that prevent the immune system from responding properly to this type of treatment.