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Intradermal testing for autoimmune progesterone dermatitis: should we be basing the diagnosis on it?
1Occupational Dermatology Research and Education Centre, Melbourne, Vic., Australia.
Clinical and Experimental Dermatology
|April 3, 2021
Summary
Autoimmune progesterone dermatitis (APD) diagnosis using intradermal progesterone testing (IPT) is questionable. Many healthy individuals also show positive skin reactions, suggesting IPT may not be a reliable diagnostic tool for APD.
Area of Science:
- Dermatology
- Immunology
- Reproductive Endocrinology
Background:
- Autoimmune progesterone dermatitis (APD) is a rare condition linked to progesterone hypersensitivity during the menstrual cycle's luteal phase.
- Traditional diagnostic methods include intradermal progesterone testing (IPT) or intramuscular progesterone challenge.
Observation:
- A case study involved a 31-year-old woman with suspected APD who underwent IPT.
- The patient exhibited cyclical symptoms and positive skin reactions post-IPT, consistent with APD.
- However, 9 out of 10 healthy controls also showed positive skin reactions to IPT, though less pronounced.
Findings:
- Intradermal progesterone testing (IPT) demonstrated positive skin reactions in both a suspected APD patient and most healthy controls.
- The high rate of positive reactions in healthy individuals challenges the specificity of IPT for diagnosing APD.
Implications:
- The validity of using intradermal progesterone testing (IPT) as a standalone diagnostic tool for autoimmune progesterone dermatitis (APD) is questioned.
- Further research is necessary to establish accurate and reliable diagnostic methods for APD.
- This study highlights the need for revised diagnostic criteria for APD, considering potential false positives with current testing.
