Post-menopausal cyclic eruptions: autoimmune progesterone dermatitis

Autoimmune progesterone dermatitis: treatment with oophorectomy

“… 25 Oestrogen dermatitis, a recently characterized entity which also presents as significant premenstrual flares of skin lesions, 26 was in the past misdiagnosed as autoimmune progesterone dermatitis 27 . Nowadays, the diagnosis of autoimmune progesterone dermatitis requires a recurrent eruption related to the menses and the demonstration of progesterone sensitization by means of skin tests with intradermal injection of progesterone, 1 , 3 , 6 , 7 , 10 , 15 , 16 , 28 , 29 the oral 11 , 12 , 14 or intramuscular administration of progesterone 1 , 6 , 13 , 14 , 19 as challenge tests, basophil degranulation tests 2 , 12 or the detection of circulating serum antibodies to progesterone (antibodies to the luteinizing cells of the corpus luteum) 1 ,. 2 , 7 , 9 …”

“…Although the relief of symptoms has occasionally been obtained with systemic corticosteroids, 10 , 14 , 29 the goal of the treatment is to inhibit the secretion of endogenous progesterone by the suppression of ovulation. Pharmacological treatment with ethinyloestradiol, 8 , 12 conjugated oestrogens 1 –3 , 6 , 15 , 17 , 18 or tamoxifen 13 , 14 , 30 is of value in most cases.…”

“…Nevertheless, due to the low incidence of this disease, there is no experience in long‐term treatment. Spontaneous amelioration or clearing has been reported in a few cases, 7 , 8 , 16 , 29 but a long‐term disease must be expected. In such instances, conjugated oestrogens therapy is of limited value because their effects on endometrial proliferation are not balanced by progestagens, which may favour malignant transformation in endometrial tissue.…”

Urticarial lesions: If not urticaria, what else? The differential diagnosis of urticaria

“…60,61 Autoimmune progesterone dermatitis has also been reported in two postmenopausal women receiving oral progesterone replacement therapy for the treatment of climacteric symptoms. 62 Cutaneous manifestations are variable and include true urticaria (in approximately 50% of reported cases), urticarial eruptions, eczematous eruptions, vesiculopustular eruptions, fixed drug eruptions, stomatitis, erythema multiformeelike lesions, and anaphylaxis (about 10 cases). 63,64 There are no specific histologic markers to support the diagnosis, and the features may vary according to the clinical type of lesion.…”

A Case of Autoimmune Progesterone Dermatitis in an Adolescent Female

“…This disorder is not limited to ovulating females, however. It has also been reported in a man taking exogenous synthetic progesterone, 2 in post-menopausal women taking hormone replacement therapy, 3 and in the post-partum period. 4 The first description of allergy to endogenous hormones such as progesterone was reported in the medical literature in 1945.…”