Steroid hormone hypersensitivity: clinical presentation and management

Itsekson, Alek M.; Seidman, Daniel S.; Zolti, Matityahu; Alesker, Michael; Carp, Howard

doi:10.1016/j.fertnstert.2011.05.025

Cited by 25 publications

(25 citation statements)

References 26 publications

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“…Similar mechanisms have been proposed for progesterone autoimmunity . Previous exposure to progesterone in oral contraceptives or during pregnancy in predisposed individuals leads to hypersensitivity to endogenous hormones and APD in later life . However, APD resolves during pregnancy .…”

Section: Autoimmune Progesterone Dermatitis and Oestrogen Dermatitismentioning

confidence: 55%

“…13,14 Oestrogen is processed by the skin as a foreign antigen and presented to immunocompetent cells, leading to an autoimmune response to endogenous oestrogen. 15 Similar mechanisms have been proposed for progesterone autoimmunity. 16 Previous exposure to progesterone in oral contraceptives or during pregnancy in predisposed individuals leads to hypersensitivity to endogenous hormones Oestrogen Progesterone Ovulation Figure 1 The menstrual cycle begins with onset of menstruation on day 1, and the thickened endometrium is shed over 4-6 days (menstrual phase).…”

Section: Autoimmune Progesterone Dermatitis and Oestrogen Dermatitismentioning

confidence: 61%

“…Oestrogen is processed by the skin as a foreign antigen and presented to immunocompetent cells, leading to an autoimmune response to endogenous oestrogen . Similar mechanisms have been proposed for progesterone autoimmunity .…”

Section: Autoimmune Progesterone Dermatitis and Oestrogen Dermatitismentioning

confidence: 75%

“…OD has also been shown to respond to the anti‐oestrogen agent tamoxifen . Hormone desensitization has been tried as a potential treatment, although this is not used routinely in clinical practice …”

Section: Autoimmune Progesterone Dermatitis and Oestrogen Dermatitismentioning

confidence: 99%

“…ª 2015 British Association of Dermatologists and APD in later life. 12,15 However, APD resolves during pregnancy. 17 It is suggested that the gradual rise of progesterone during pregnancy acts as a desensitizing agent, ultimately reducing symptoms.…”

Section: Dermatosis Referencesmentioning

confidence: 99%

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The menstrual cycle and the skin

2015

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Perimenstrual exacerbations of dermatoses are commonly recognized, yet our knowledge of the underlying pathophysiological mechanisms remains imperfect. Research into the effects of oestrogen on the skin has provided evidence to suggest that oestrogen is associated with increases in skin thickness and dermal water content, improved barrier function, and enhanced wound healing. Research into the effects of progesterone suggests that the presence of various dermatoses correlates with peak levels of progesterone. Dermatoses that are exacerbated perimenstrually include acne, psoriasis, atopic eczema and irritant dermatitis, and possibly also erythema multiforme. Exacerbations occur at the peak levels of progesterone in the menstrual cycle. Underlying mechanisms include reduced immune and barrier functions as a result of cyclical fluctuations in oestrogen and/or progesterone. Autoimmune progesterone and oestrogen dermatitis are the best-characterized examples of perimenstrual cutaneous reactions to hormones produced during the menstrual cycle. In this review, we describe the current understanding of the menstrual cycle, and its effect on the skin and cutaneous disorders.

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Section: Autoimmune Progesterone Dermatitis and Oestrogen Dermatitismentioning

confidence: 55%