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Autoimmune Progesterone Dermatitis (APD)

Written by
Dr. Potnuru Srinivaasa Sudhakar
and medically reviewed by iCliniq medical review team.

Published on Oct 06, 2018 and last reviewed on Mar 06, 2023   -  1 min read

Abstract

This article deals with the treatment of autoimmune progesterone dermatitis (APD) through homeopathy.

Autoimmune Progesterone Dermatitis (APD)

Autoimmune progesterone dermatitis (APD) is characterized by skin rashes whose severity is directly dependant on the phase of the menstrual cycle. It appears at the second half of the menstrual cycle during which the progesterone begins to rise. The rashes subside immediately after menstruation ends.

Cause

The exact cause of autoimmune progesterone dermatitis is unknown. It is believed to be due to an autoimmune reaction to a woman’s own progesterone. The conventional treatment involves the application of topical medications, corticosteroids, and hormones to suppress the secretion of progesterone or in severe cases, removal of ovaries.

It develops during the luteal phase of the menstrual cycle. It can be confirmed by progesterone intradermal test, which produces skin rashes. The female may develop skin rashes from few days before the menses and it disappears a few days later menses.

Each patient who suffers from autoimmune progesterone dermatitis presents with different skin lesions like erythematic skin lesions, urticaria and contact dermatitis with various clinical manifestations which can often lead to misdiagnosis.

APD is a rare autoimmune disorder due to endogenous or exogenous progesterone. It may be due to a hypersensitivity reaction to endogenous progesterone. It may appear from the first menses (menarche) onwards.

Diagnosis

Skin lesions associated with menses.

Dermatitis develops three to 10 days before menses and remains up to one to two days after stoppage of menses.

Progesterone intradermal test is positive.

Symptoms improve by suppressing the secretion of progesterone and ovulation.

Symptoms

  • Hives.
  • Erythema multiforme.
  • Angioedema.
  • Rash like eczema.
  • Round erythematic skin lesions.
  • Sores in the mouth.

Homeopathic Treatment

Ars, Apis, Sepia, and Psorinum.

Frequently Asked Questions


1.

Is There a Cure for Autoimmune Progesterone Dermatitis?

Autoimmune progesterone dermatitis can be cured or controlled mainly by suppressing ovulation. The initial therapy is provided using combined oral contraceptives. The affected individuals are treated with antihistamines, oral contraceptives, and steroids.

2.

How Does Autoimmune Progesterone Dermatitis Clinically Present Itself?

The clinical signs and symptoms include:
- Hives.
- Erythema multiforme.
- Angioedema.
- Rashes similar to eczema.
- Round erythematous skin lesions.
- Sores in the mouth.

3.

How Long Does Autoimmune Progesterone Dermatitis Take To Heal?

The signs and symptoms of autoimmune progesterone dermatitis are skin lesions that appear three to ten days before menstruation and last up to one to two days after the end of the menstrual cycle, with recurrent aggravation. It is closely related to progesterone levels.

4.

What Are the Signs and Symptoms of Progesterone Hypersensitivity?

Progesterone hypersensitivity is triggered by exogenous progestins or endogenous progesterone used for contraception or fertility treatments. Symptoms include:
- Urticaria.
- Dermatitis.
- Asthma.
- Anaphylaxis.

5.

Who Is More Prone to Get Autoimmune Progesterone Dermatitis?

Autoimmune progesterone dermatitis is seen in women mainly due to progesterone surge during the menstrual cycle. It is common in young adult women in the age group of 27 years. It is also seen in adolescents after menarche or in premenopausal women.

6.

What Are the Investigations for Progesterone Allergy?

An intradermal test can be used to diagnose progesterone allergy. Both immediate and late reactions may occur. If erythema or wheal appears at the aqueous suspension of progesterone within 48 hours or immediately, then the test is positive.

7.

Is There a Cure for Autoimmune Progesterone Dermatitis?

Autoimmune progesterone dermatitis can be cured or controlled mainly by suppressing ovulation. The initial therapy is provided using combined oral contraceptives. The affected individuals are treated with antihistamines, oral contraceptives, and steroids.

8.

What Are the Ways to Reduce Progesterone Sensitivity?

Progesterone sensitivity can be managed by suppression of symptoms with anti allergy medications, desensitization, and Omalizumab therapies to suppress ovulation, using a selective estrogen receptor modulator such as Tamoxifen and oophorectomy.

9.

Can Progesterone Hypersensitivity Be Developed Later in Life?

Progesterone hypersensitivity is also called autoimmune progesterone dermatitis. It is a hypersensitivity reaction to progesterone or synthetic progestins. The clinical presentation can develop anytime from menarche to menopause in reproductive-aged women.

10.

What Is the Etiology of Progesterone Hypersensitivity?

The cause of autoimmune progesterone dermatitis is unknown. But it may be due to an autoimmune reaction to a woman's own progesterone. It develops during the luteal phase of the menstrual cycle. The diagnosis is confirmed by an intradermal test.

11.

Does Progesterone Affect Histamine?

During the menstrual cycle, there is a hormonal breakdown of histamine in the body. The breakdown of histamine corresponds to the levels of productive hormones such as:
- Estrogen.
- Progesterone.
- Luteinizing hormone.
- Follicle-stimulating hormone.

12.

How Is Progesterone Different From Progestogen?

Progestogens are synthetic forms of progesterone. Progestogens were developed because progesterone could not be absorbed orally. Progesterone is a naturally occurring steroid hormone made in different amounts by female, male and intersex bodies.

13.

Does Hormone Imbalance Cause a Skin Rash?

Decreased levels of estrogen can lead to itchy, irritated, or sensitive skin. Further scratching and itchy skin can cause rashes and hives. In addition, the skin may become excessively dry due to hormonal imbalance.

Last reviewed at:
06 Mar 2023  -  1 min read

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