Progesterone Autoimmune Dermatitis With Positive Autologous Serum Skin Test Result

Abstract

Skin tests with progesterone and autologous serum, which are easy to perform, convenient, and inexpensive, are highly useful for establishing the diagnosis of progesterone autoimmune dermatitis and ruling out other skin disorders.

Gonadotropin-Releasing Hormone Agonist Use to Guide Diagnosis and Treatment of Autoimmune Progesterone Dermatitis

“…2 Other proposed treatment options include danazol, tamoxifen, and GnRH agonists. [1][2][3][4] Surgical therapy with bilateral salpingo-oophorectomy can also be considered as a definitive treatment method and can lead to cure in patients with autoimmune progesterone dermatitis. [1][2][3][4][5] In young women who desire fertility, more conservative medical treatment options as described previously should be considered.…”

“…[1][2][3][4] Surgical therapy with bilateral salpingo-oophorectomy can also be considered as a definitive treatment method and can lead to cure in patients with autoimmune progesterone dermatitis. [1][2][3][4][5] In young women who desire fertility, more conservative medical treatment options as described previously should be considered. 6 Our case illustrates successful use of GnRH agonist with add-back oral progesterone as a means of diagnosing autoimmune progesterone dermatitis and guiding future treatment using techniques familiar and commonly available to gynecologists.…”

“…2 Diagnostic criteria have been suggested and include: a cyclic rash in the luteal phase of the menstrual cycle, symptom resolution with ovulation suppression, and exacerbation of symptoms with progesterone provocation. [2][3][4] Progesterone provocation methods typically involve progesterone skin testing. [1][2][3]5 However, case reports have demonstrated use of progesterone pessary or intravaginal progesterone tablets as means of provocation.…”

“…[2][3][4] Progesterone provocation methods typically involve progesterone skin testing. [1][2][3]5 However, case reports have demonstrated use of progesterone pessary or intravaginal progesterone tablets as means of provocation. 2,4 Progesterone provocation in this manner, however, fails to allow the physician the opportunity to assess effects of endogenous progesterone production or to trial exogenous progesterone therapy in a controlled fashion, guiding future treatment of the patient's illness.…”

Cyclic Catamenial Dermatoses

“…However, not all women with AIPD had been previously exposed to synthetic progestogens. The evidence for autoimmunity to progesterone is supported by (a) positive controlled intradermal tests and response to anovulatory drugs, (b) recurrence on intramuscular or oral progesterone challenge, and (c) demonstration of circulating antibodies to progesterone [18]. …”