Autoimmune progesterone dermatitis

Abstract

Autoimmune progesterone dermatitis is a rare cutaneous disorder characterized by recurrent cyclic eruptions during the luteal phase of the menstrual cycle. We describe a woman with postpartum onset of a papulovesicular eruption. The possibility of autoimmune progesterone dermatitis was raised because of the cyclic nature of the outbreak. A reactive intradermal progesterone test confirmed the diagnosis. A review of individual case reports is also presented.

Sex hormones and urticaria

“…The mechanism of such autoimmune reaction to progesterone is unknown. In some patients, the onset of the disorder occurs after the hormonal therapy (containing progesterone), suggesting that synthetic progesterone may induce cross-reaction against the endogenous hormone [34][35][36][37]. This disorder can also appear or aggravate during pregnancy, possibly because the increasing progesterone levels occurring during such period may promote the immunological imbalance responsible for progesterone hypersensitivity.…”

“…On one hand, hypersensitivity to progesterone may be a causal factor of urticaria symptoms in patients suffering from autoimmune progesterone dermatitis [34][35][36][37], while on other hand, endogenous and exogenous progesterone may lead to improvement in urticaria symptoms [28].…”

Autoimmune progesterone dermatitis in a parturient for emergency caesarean section

“…In severe cases, recurrent angioedema may lead to laryngeal oedema resulting in significant morbidity. 1 Autoimmune progesterone dermatitis may be diagnosed on the basis of the cyclic eruptions together with demonstration of anti-progesterone antibodies.…”

Tema 7-2014: Dermatitis Autoinmune, Urticaria Ciclica/Angioedema Y Anafilaxis Por Progesterona

“…Sin embargo, no se sabe bien aún cómo en pocas mujeres el ciclo menstrual puede inducir un espectro de condiciones alérgicas cíclicas, con una variedad de presentaciones en las que se incluyen urticaria, eczema, angioedema y aún, más raramente, síntomas de asma o anafilaxia (5) que aparecen o son exacerbados cíclicamente en la fase lútea del ciclo y resuelven total o parcialmente después de la menstruación (6) .…”