The histopathologic features of autoimmune progesterone dermatitis

Abstract

Background:The histologic features of autoimmune progesterone dermatitis (APD) are generally non-specific and have been described only in brief case reports. We present a case of APD and review the literature with a focus on the histologic findings described. Methods: A review of the English literature on APD was performed using PubMed and MEDLINE. Results: A total of 39 patients, including our patient are included in this review. The most consistent histologic finding reported was a perivascular inflammatory infiltrate, being seen in 72% of cases. A non-specific or interstitial inflammatory infiltrate was described in 31% of the cases, with 41% having an eosinophilic component and 21% having a neutrophilic component mixed with the predominant lymphocytic infiltrate. Interface dermatitis was the second most common finding with 36% showing a mild to exaggerated interface dermatitis. Conclusion: Although histopathologic changes are non-specific, perivascular dermatitis with eosinophils and interface changes are common in APD.Keywords: autoimmune progesterone dermatitis, histopathology of autoimmune progesterone dermatitis, progesterone allergy, progesterone anaphylaxis James T, Ghaferi J, LaFond A. The histopathologic features of autoimmune progesterone dermatitis.

Case of fertility treatment‐induced Stevens‐Johnson syndrome with a severe ocular complication

“…Although the pathophysiology of APD is not well understood, it can develop due to a cyclic premenstrual allergic reaction to a woman's own progesterone. Autoimmune progesterone dermatitis occasionally presents with mucocutaneous lesions, which histopathologically show interface dermatitis . An APD presenting with mucocutaneous symptoms resembling SJS has been reported; however, in that case, the characteristic clinical features of SJS, such as flat atypical target lesions and skin detachment, and histopathologically confirmed pan‐epidermal necrosis, which were observed in our case, were not reported.…”

“…Autoimmune progesterone dermatitis occasionally presents with mucocutaneous lesions, 8,9 which histopathologically show interface dermatitis. 10,11 An APD presenting with mucocutaneous symptoms resembling SJS has been reported; 9 however, in that case, the characteristic clinical features of SJS, such as flat atypical target lesions and skin detachment, and histopathologically confirmed pan-epidermal necrosis, which were observed in our case, were not reported. Moreover, there was no recurrence of the mucocutaneous lesions for more than 2 years after the onset of SJS in our case, thus, excluding a diagnosis of APD.…”

Progesterone Hypersensitivity in Assisted Reproductive Technologies: Implications for Safety and Efficacy

“…This has not come as a surprise as symptom appearance upon intravaginal progesterone administration in patients with autoimmune progesterone dermatitis during infertility treatment has also been previously reported [12]. Histopathologic findings in APD are generally nonspecific and often align with the morphology of the lesions [55,75].…”

Autoimmune Progesterone Dermatitis: A Systematic Review

“…One hundred twelve articles were found to include a case report meeting our inclusion criteria 3–114 . Within these articles, 132 unique cases of AIPD were identified.…”