Autoimmune progesterone dermatitis: a retrospective case series.

Area of Science:

• Dermatology
• Immunology
• Endocrinology

Background:

• Autoimmune progesterone dermatitis (APD) is a rare hypersensitivity disorder.
• It presents with recurring dermatologic manifestations during the luteal phase of the menstrual cycle.
• Currently, well-defined clinical and diagnostic criteria, outcomes measurements, and standard treatments are lacking.

Purpose of the Study:

• To review adult patients diagnosed with APD.
• To analyze clinical characteristics, diagnostic delays, and treatment outcomes in APD patients.
• To identify common presentations and effective management strategies for APD.

Main Methods:

• A single-institution retrospective review was conducted.
• Adult patients (older than 20 years at diagnosis) with APD were included.
• Data on clinical onset, diagnosis delay, triggers, diagnostic tests, presentations, and treatments were analyzed.

Main Results:

• Fourteen patients were included with a mean age of onset of 34.3 years.
• A significant delay of 3.9 years was observed between symptom onset and diagnosis.
• Urticaria (64.3%) and dermatitis (28.6%) were common presentations; exogenous progesterone exposure preceded APD in 9/14 patients.
• Continuous combined oral contraceptives, GnRH agonist, and hysterectomy with bilateral salpingo-oophorectomy were common treatments.

Conclusions:

• APD is a rare disorder with diagnostic challenges leading to significant delays.
• There is a need for large-scale multicenter studies to develop accurate diagnostic tests and criteria.
• Further research is required to establish standardized treatment protocols and define outcomes for APD.