Autoimmune progesterone dermatitis

Autoimmune progesterone dermatitis (APD) is an uncommon cutaneous disorder characterized by exacerbations during the luteal phase of the menstrual cycle. We describe a 27-year-old woman with a recurrent skin eruption for 3 years. She had no history of exposure to synthetic progesterones. At each menses, the patient developed scaly, erythematous maculopapular lesions over the face. Intradermal skin test reaction to progesterone was positive. Progesterone sensitivity was also demonstrated by challenge test with intramuscular progesterone acetate. These features were consistent with the diagnosis of APD. Our patient was treated successfully with conjugated estrogen for 6 months. At one year follow-up, the patient had had no recurrence of facial eruption.     

Autoimmune progesterone dermatitis

Autoimmune progesterone dermatitis is a rare cutaneous disorder characterized by recurrent cyclic eruptions with variable morphology occurring during the luteal phase of the menstrual cycle. We report a case of a 40-year-old woman with recurrent pruritic eruptions of 8 years' duration. The possibility of autoimmune progresterone dermatitis was raised because of the cyclic nature of the exacerbations. We used oral estrogen both to confirm the diagnosis and to treat the patient. A brief review of the clinical features of the disease is also presented.     

Autoimmune progesterone dermatitis with summertime remission

An unusual case of autoimmune progesterone dermatitis is reported. The lesions followed a cyclical pattern, with premenstrual flares and a tendency to improve spontaneously at the start of menstruation, but the patient did not experience any exacerbation of her skin lesions in the summer months (June, July, August).     

Autoimmune progesterone dermatitis.

A 35-year-old woman had recurrent urticarial erythemas on her trunk and extremities for 3 years. The eruptions appeared regularly 3 to 5 days prior to menstruation and persisted for several days. The patient showed a positive skin test response to progesterone and had circulating antiprogesterone IgG antibodies. A speculative concept of the possible autoimmune damage to the ovary, the major organ producing progesterone, is discussed.     

Autoimmune progesterone dermatitis.

Seven patients had autoimmune progesterone dermatitis. The morphological findings illustrate the polymorphous nature of the disease in which urticaria, erythema multiforme, and dyshidrosiform lesions were seen. Recurrence of the eruption five to ten days prior to the menses with spontaneous resolution following the menses was present in all cases. Intradermal skin testing to progesterone was done to confirm the diagnosis. Six of the seven patients has a history of use of artificial progestational hormones prior to the beginning of their eruption. It is postulated that the artificial progesterones may have been the trigger for the development of their autosensitivity. Treatment with conjugated estrogens resulted in remission of the disease in five of the seven cases reported.     

Autoimmune progesterone dermatitis: treatment with oophorectomy

Autoimmune progesterone dermatitis is a rare manifestation of hypersensitivity to endogenous hormones with polymorphic clinical manifestations. We report a 28-year-old woman with a 5-year history of mucocutaneous erythema multiforme occurring cyclically in the premenstrual period. Progesterone sensitivity was demonstrated by challenge test with medroxyprogesterone acetate. Treatments with oestrogens, tamoxifen and triptorelin had to be withdrawn because of intolerable adverse effects. Oophorectomy finally cured the disease.     

自身免疫性孕酮皮炎的研究进展

自身免疫性孕酮皮炎（autoimmune progesterone derma?titis,APD）是一种孕酮引发的自身免疫反应,也称为孕酮超敏反应（progestogen hypersensitivity）,本病最早于1921年由Geber等报道。1964年,Shelley等命名为自身免疫性孕酮皮炎。多见于育龄女性,常在月经前10 d出现皮疹,月经前达到高峰,月经开始后皮疹自行缓解。皮疹形态以荨麻疹最为常见,也可以表现为丘疹、丘疱疹、水疱、脓疱、紫癜、固定性药疹、环形红斑和多形红斑样。皮疹主要累及躯干、四肢,累及黏膜时主要表现为口腔黏膜糜烂溃疡［1］……     

Autoimmune progesterone dermatitis responding to Tamoxifen

A case of autoimmune progesterone dermatitis is described. Exacerbation occurred premenstrually and after intramuscular and oral challenge with synthetic progesterone. The condition failed to respond to oestrogen, but there has been a marked improvement with the anti-oestrogen drug Tamoxifen.     

Autoimmune progesterone dermatitis: effective prophylactic treatment with danazol

Background Autoimmune progesterone dermatitis is a rare condition appearing during the perimenstrual period or following progesterone treatment. Various treatment modalities have been suggested, but most have proved to be ineffective. Methods We used the anabolic androgen danazol as a preventive treatment for recurrent episodes of autoimmune progesterone dermatitis in two young women. The treatment regimen consisted of 200 mg danazol twice daily, starting 1–2 days before the expected date of each menses and continuing for 3 days thereafter. Results This treatment regimen proved to be highly effective in preventing the eruptions in these two patients. Conclusions Patients with autoimmune progesterone dermatitis may benefit from prophylactic treatment with danazol.     

自身免疫性孕酮皮炎

报告1例自身免疫性孕酮皮炎.患者女,22岁.面部反复出现红斑2年余,伴有明显灼热感.皮损一般在经期前3～5d加重,月经过后逐渐减轻.黄体酮皮试阳性,而雌二醇皮试和生理盐水对照试验为阴性.     

Autoimmune progesterone dermatitis: a diagnosis easily missed

Autoimmune progesterone dermatitis (AIPD) is a rare, poorly characterized dermatosis, with about 60 previously reported cases. It typically undergoes cyclical flares relating to the menstrual cycle, especially the luteal phase, when levels of progesterone are at their highest. We report the case of a 34-year-old woman with an 8-year history of a profoundly pruritic eruption, associated with her menstrual cycle, in whom the diagnosis had proved elusive. Buserelin nasal spray resulted in complete clearance. AIPD is a diagnosis to consider in intractable eruptions in women, particularly if there is cyclical variation.     

Autoimmune progesterone dermatitis manifesting as generalized fixed drug eruption

Autoimmune progesterone dermatitis is an uncommon, poorly recognized and under-diagnosed catamenial dermatosis associated with hypersensitivity reactions to progestagens. Most cases manifest as urticaria, eczema or erythema multiforme-like. A 26-year-old woman developed violaceous plaques on the groin and abdomen, 4 days after a spontaneous abortion resolved with uterine curettage. The lesions recurred once monthly at the same sites, mimicking a fixed drug eruption. Although the histopathology was compatible with fixed drug eruption, positive intradermal testing and symptomatic improvement after using oral contraceptive pills gave us a clue to the diagnosis.