Autoimmune progesterone dermatitis: Update and insights

Autoimmune progesterone dermatitis manifesting as mucosal erythema multiforme in the setting of HIV infection

“…Although HSV is commonly touted to be the most frequent trigger, retrospective studies identified HSV infection as the cause in only 17.5-23.0% of cases 3, 4. Multiple additional triggers are documented including, as in this case, EM driven by progesterone, one morphologic variety of APD 5, 6…”

“…APD is an uncommon mucocutaneous disease characterized by cyclical alterations in skin and mucosa; variable morphologies include EM, urticaria, anaphylaxis, fixed drug, and vesiculobullous eruptions 6 . Flares occur approximately 3 to 10 days before menses as serum progesterone levels increase.…”

Estrogen dermatitis: Case report and examination of estrogen receptor‐β in the skin

“…4 Although there is a huge intra-and inter-patient variation in the association of skin symptoms with the menstrual cycle, a key clue to reaching a diagnosis is to notice the potential relationship between skin reaction and menstrual cycle in women of child-bearing age. 3 Its etiology is said to be autoimmunity against the subject's own progesterone. There are two categories of skin eruptions directly associated with sex hormones, which are stratified based on the intradermal test results: autoimmune progesterone dermatitis (APD) or estrogen dermatitis.…”

“…Thus, histopathological findings are nonspecific and often correlate with the nature of lesions. 2,3 The hallmark of estrogen dermatitis is the cyclic premenstrual flare. Symptoms generally appear 3-10 days prior to menses, and remit shortly after menstruation.…”

Chronological clinical and pathological documentation of porcine ulcerative dermatitis

“…The correlation of PUDS with gestation suggests that the pathogenesis is associated with gestational factors such as hormonal changes or placental or fetal development. Whereas autoimmune progesterone dermatitis may be seen in association with human pregnancy, plasma progesterone levels in pregnant sows follow a different concentration time course . In humans, the fetus is proposed to be a semi‐allogeneic graft which induces a fetal–maternal immune reaction, resulting in maternal disease .…”