The possible relevance of sex hormones on irritant and allergic responses: their importance for skin testing

Abstract

Dermatological responses are affected by the menstrual cycle phase in female patients, an unsurprising observation as oestrogen and progesterone affect the skin and immunological function, with oestrogen suppression of cellular immunity in particular. Exacerbation of dermatological symptoms is typically observed in either the latter phase of the menstrual cycle or during menstruation. The allergic response is diminished in the ovulatory phase and heightened in the progestinic phase. Definitive conclusions with regard to the effect of reproductive hormones on skin disorders have been somewhat hampered by a body of research that has employed diverse research parameters, such as dosage, testing sites, concentration, vehicle of irritant delivery, and method of assessment, however, individual patient sensitivity varies widely. Standardization of measurement techniques is necessary to provide reproducible results as much as individual patient variation and technique will allow.

Inhibition by Female Sex Hormones of Collagen Gel Contraction Mediated by Retinal Pigment Epithelial Cells

“…34,35 We found that 17b-estradiol and progesterone each at a relatively high concentration inhibited the TGF-b2-induced production of IL-6 by cultured mouse RPE cells, with the effect of 17b-estradiol appearing greater than that of progesterone. It is thus possible that 17b-estradiol might prove more effective than progesterone for immunosuppression in the eye.…”

The menstrual cycle and the skin

“…Nearly half of all patients with atopic eczema experience deterioration in their condition in the week prior to the menstruation, with the exacerbation rapidly settling after the onset of menstrual flow . Skin barrier permeability is greater just prior to menstruation . This increases the susceptibility of skin to the effects of both environmental allergens and general irritants, which partially explains the premenopausal flares of eczema in some women …”

“…Acne vulgaris 4,10 Aphthous ulceration 4,10 Atopic eczema 4,23 Autoimmune progesterone dermatitis 13,14,16,18 Autoimmune oestrogen dermatitis 12 Dermatitis Herpetiformis 4 Erythema multiforme 4 Herpes simplex Oestrogen Progesterone Ovulation Figure 2 Timescale showing when different perimenstrual dermatoses commonly occur during the menstrual cycle, e.g. APD occurs 3-10 days before and 5-10 days after menstruation.…”

Estriol strongly inhibits DNCB-induced contact dermatitis: role of antigen-specific antibodies in pathogenesis

“…First, estrogens are known to promote skin elasticity and improve wound healing (36). Second, it was reported that skin response to allergens is markedly stronger at follicular phase than during ovulation (37, 38, 39). Third, Bonamonte et al .…”