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Erythema multiforme associated with autoreactivity to 17 alpha-hydroxyprogesterone.
J S Pinto1, L Sobrinho, M B da Silva
1Department of Dermatology, Faculty of Medical Sciences, Portuguese Cancer Institute, Lisbon.
Dermatologica
|January 1, 1990
Summary
This case study details a woman with recurrent erythema multiforme linked to 17 alpha-hydroxyprogesterone (17-OHP) autoimmunity. Her unique immune response involved chromatin activation and reduced HLA antigen expression, suggesting a novel autoimmune mechanism.
Area of Science:
- Immunodermatology
- Reproductive Endocrinology
- Autoimmunity
Background:
- Erythema multiforme is an acute, immune-mediated condition often triggered by infections or medications.
- Hormonal fluctuations, particularly during the menstrual cycle and pregnancy, can influence dermatological conditions.
Observation:
- A 23-year-old woman presented with recurrent, disseminated erythema multiforme-like skin eruptions.
- Lesions correlated with menarche, premenstrual periods, and pregnancy, resolving post-abortion.
- Skin manifestations responded significantly to thalidomide therapy.
Findings:
- Serum analysis revealed a high-affinity binding factor for 17 alpha-hydroxyprogesterone (17-OHP).
- Patient's lymphocytes exhibited chromatin activation upon 17-OHP exposure but no proliferation.
- Reduced expression of Human Leukocyte Antigen (HLA) on blood lymphocytes was observed.
Implications:
- This case suggests a potential autoimmune etiology of erythema multiforme directed against 17-OHP.
- The findings highlight a unique immune response involving chromatin activation and altered HLA expression.
- Further research is needed to elucidate the precise mechanisms of 17-OHP autoimmunity in dermatological conditions.