Autoimmune progesterone dermatitis

Alternate names

APD; autoimmune progesterone dermatitis

Definition

Progestogen hypersensitivity causes a skin reaction that typically occurs during a woman's menstrual cycle.

Epidemiology

• It can be difficult to estimate the exact number of people affected by a rare condition.
• Some people may go undiagnosed or may be diagnosed incorrectly.
• Others may not seek medical care.
• The following information is based on the best information available in the medical literature.
• This estimate can change over time based on new information.
• There have been about 200 case reports of progestogen hypersensitivity in the medical literature.
• It is unclear exactly how many people have progestogen hypersensitivity.

Cause

• The exact cause of progestogen hypersensitivity is not known.
• Many women with progestogen hypersensitivity have had exposure to an external source of progesterone such as oral contraceptives or drugs used in fertility treatments.
• However, some women develop progestogen hypersensitivity in response to the progesterone made naturally by the body.

Onset

• The symptoms of progestogen hypersensitivity usually begin in the late 20s.
• Symptoms first appear a few days before a woman starts her period and go away after her period is over.

Signs and symptoms

The following list includes the most common signs and symptoms in women with progestogen hypersensitivity. These features may be different from person to person. Some people may have more symptoms than others, and they can range from mild to severe. This list does not include every symptom that has been described in the condition.

Symptoms of progestogen hypersensitivity include:

• Hives
• Flu-like symptoms with skin lesions (erythema multiforme)
• Swelling beneath the skin (angioedema)
• Bumps and red, flaky areas on the skin
• Mouth sores
• Rarely, progestogen hypersensitivity may cause respiratory symptoms such wheezing and difficulty breathing. Progestogen hypersensitivity ends after a woman stops having periods (menopause).

Diagnosis

The diagnosis of progestogen hypersensitivity is based on the symptoms, clinical exam, and a skin test to look for evidence of a skin reaction to progesterone.

Treatment

• Treatment of progestogen hypersensitivity is focused on managing the symptoms.
• Treatment typically involves the use of medications that block the action of progesterone or stop it from being made by the body.
• Medications may include oral contraceptives, steroids, tamoxifen, and gonadotropin-releasing hormones. Some women have been treated with progesterone desensitization.
• For severe cases, surgical removal of ovaries (an oophorectomy) is curative.

Specialists involved in the care of someone with progestogen insensitivity may include:

• Obstetrician/gynecologist
• Endocrinologist
• Dermatologist

NIH genetic and rare disease info

• NIH info on Autoimmune progesterone dermatitis

Autoimmune progesterone dermatitis is a rare disease.

Autoimmune progesterone dermatitis Resources
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