Autoimmune progesterone dermatitis presenting with purpura and petechiae

Autoimmune progesterone dermatitis: clinical presentation and management with progesterone desensitization for successful in vitro fertilization

“…Skin lesions include urticaria, angioedema, erythema multiforme, eczema, folliculitis, papulovesicular eruptions, fixed drug eruption, purpura, or vulvovaginal pruritus (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Anaphylaxis is also reported (21)(22)(23).…”

Autoimmune progesterone dermatitis: Case report with history of urticaria, petechiae and palpable pinpoint purpura triggered by medical abortion

“…[6] The use of systemic glucocorticoids, usually in high doses, has been reported to control the cutaneous lesions of APD in some cases. [4,6,18,25] This patient was also treated with topical steroids prior to our confirmed diagnosis. Several treatment modalities have been used in the treatment of APD.…”

“…Other researchers have correlated the presence of APD skin conditions with increased eosinophils levels. [4,6,18,25] In this case the first clinicians failed to link the appearance of current symptoms with APD. This is very common to many patients with APD.…”

“…Skin test results with progesterone have shown immediate reactions (within 30 minutes), delayed reactions (24 -48 hours later) and reactions with both immediate and delayed features. [4,6,18,25] This presumably indicates both type I and type IV hypersensitivity reactions. Progesterone has also been reported to have a direct histamine-releasing effect on mast cells and in one study found an in vitro increase of an interferon-γ release assay, likely from TH1-type cytokines.…”

“…[6,[28][29][30] However, side-effects include symptoms of oestrogen deficiency (hot flushes, vaginal dryness and decreased bone mineral density) and oestrogen supplementation may be needed. [6,25] Alkylated steroids such as stanozol have been used to successfully suppress ovulation, sometimes in combination with chronic low doses of corticosteroids. Side-effects of alkylated steroids include abnormal facial or body hair growth, hepatic dysfunction and mood disorders.…”