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Diseases

Genetic and Rare Diseases Information Center (GARD)

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Autoimmune progesterone dermatitis


Other Names for this Disease
  • APD
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Overview



What is autoimmune progesterone dermatitis?

How might autoimmune progesterone dermatitis be treated?


What is autoimmune progesterone dermatitis?

Autoimmune progesterone dermatitis (APD) is a rare condition characterized by a cyclic skin rash which develops premenstrually in women. The condition usually occurs in adulthood after the start of periods (menarche), and rarely during pregnancy or postmenopause.[1] Signs and symptoms vary among affected individuals; skin findings that have been reported include hives, erythema multiforme, papulovesicles (an eczema-like rash), annular erythema, angiodema, mouth erosions and pruritus (itching).[1][2] The rash typically begins a few days before menses and subsides around the time menstruation begins, recurring at the next cycle.[2] The exact cause is unknown, but is thought to involve a hypersensitivity reaction to a woman's own progesterone.[3] Depending on the severity, treatment may include topical medications, systemic corticosteroids, hormone therapy to inhibit the production of progesterone, or surgical removal of the ovaries.[2]
Last updated: 1/9/2012

How might autoimmune progesterone dermatitis be treated?

Evidence has shown that there are various possible treatments for autoimmune progesterone dermatitis (APD), depending on the symptoms and level of progesterone sensitivity that an affected woman has.[3] Mild skin problems may improve with topical steroids for eczema, or oral antihistamines for urticaria, for example. However, the condition is sometimes resistent to this type of therapy. More severe skin problems may require treatment with systemic corticosteroids.[2] Definitive treatment of APD involves agents that keep a woman from ovulating, thus suppressing the secretion of progesterone within the body.[3] This may be accomplished with hormone-based therapy, which may involve the use of estrogen, estradiol, tamoxifen, and/or danazol. Medications containing any progesterone (such as oral contraceptives) should be avoided.[2] In individuals for whom these treatments are ineffective, surgical removal of the ovaries (oophorectomy) has been shown to cure the condition.[2] In a few cases, the condition resolves on its own without treatment or during pregnancy.[1]
Last updated: 1/9/2012

References
  1. TuEgba Oskay, Lale Kutluay, Asli Kaptanocglu, Onur Karabacak. Autoimmune progesterone dermatitis. European Journal of Dermatology. November-December 2002; 12(6):589-591.
  2. Autoimmune progesterone dermatitis. DermNet NZ. December 9, 2009; http://dermnetnz.org/reactions/progesterone-dermatitis.html. Accessed 1/6/2011.
  3. Tami Maguire. Autoimmune Progesterone Dermatitis. Dermatology Nursing. 2009; 21(4):190-192. http://www.medscape.com/viewarticle/712365. Accessed 1/9/2012.