Progesterone Skin Testing: Two Irritating Scenarios

Patel, Chitranjan; Kaplan, B.

doi:10.1016/j.anai.2018.09.214

Cited by 3 publications

(3 citation statements)

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“…Thus, improved diagnostic tests are needed. 7 A progesterone-specific IgE assay for diagnosing patients with suspected APD has been recently developed, with promising diagnostic accuracy. 8 Topical corticosteroids and oral antihistamines were the most commonly administered initial treatments in our cohort, but seldom provided a durable response.…”

Section: Discussionmentioning

confidence: 99%

“…The intradermal progesterone solution may also contain irritant dilutants (benzyl alcohol and sterile olive oil) that may cause a false‐positive reaction. Thus, improved diagnostic tests are needed 7 . A progesterone‐specific IgE assay for diagnosing patients with suspected APD has been recently developed, with promising diagnostic accuracy 8 …”

Section: Discussionmentioning

confidence: 99%

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Autoimmune progesterone dermatitis in the adolescent population

Aghazadeh

Chattha

Hartz

et al. 2020

Pediatric Dermatology

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Background/Objective: Autoimmune progesterone dermatitis (APD) is a rare autoimmune hypersensitivity reaction that occurs cyclically at the peak of endogenous progesterone production during the menstrual cycle in women. No study characterizing APD in the adolescent population is found; it appears likely to be underdiagnosed and undertreated.Methods: A retrospective, single-center, review of all adolescent and pediatric patients (<20 years old at onset) with documented diagnosis of APD.Results: Seventeen adolescent APD patients were included (mean age at diagnosis: 14.4 ± 2 years, mean interval of 13.6 ± 11.1 months between symptom onset and diagnosis). Twelve patients presented with urticaria, two with fixed drug eruption.Erythema multiforme, eczema, and recurrent aphthous stomatitis were present in one patient each. Exposure to exogenous progestin was present in two patients prior to disease onset. Progesterone skin test was performed in six patients with positive results in two. Fourteen patients received antihistamines and/or a topical corticosteroid. Combined oral contraceptives (COCs) were given to eleven patients, in seven via continuous daily dosing. Gonadotropin-releasing hormone agonist (GnRHa) was used in five, progesterone desensitization in four, omalizumab in two, and danazol in one patient. Conclusions:Adolescent APD is associated with a significant delay in diagnosis. The most common manifestation is urticaria. Exogenous exposure to progestins is uncommon in adolescent APD. Continuous COC, GnRHa, and progesterone desensitization have been used to control symptoms. Large, multicenter studies are required to better define, diagnose, and treat this under recognized condition among adolescent patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Autoimmune progesterone dermatitis in the adolescent population

Aghazadeh

Chattha

Hartz

et al. 2020

Pediatric Dermatology

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“…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.…”

Section: Resultsmentioning

confidence: 99%

Autoimmune Progesterone Dermatitis: A Systematic Review

et al. 2021

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Autoimmune progesterone dermatitis (AIPD) is a cyclical, cutaneous reaction to endogenous progesterone that occurs throughout the menstrual cycle. The cutaneous manifestations of AIPD vary greatly from patient to patient, ranging anywhere from urticaria to erythema multiforme to anaphylaxis. As such, recognition, diagnosis, and management of this condition are difficult for clinicians. In the present article, we conducted a systematic review of 112 articles and 132 individual cases to summarize the clinical features and presentation of AIPD while also summarizing the successes and failures of different treatment plans. Despite the great variety in clinical presentations, it is clear from the data that ovulation-suppressing medical therapies and surgery have the greatest success in treating AIPD, whereas more commonly used therapies such as antihistamines and systemic corticosteroids frequently fail in providing any relief. Further research is necessary to determine the exact pathogenesis of AIPD and allow for more targeted treatment.

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