Nasabzadeh Teresa J, Stefanato Catherine M, Doole John E, Radfar Arash, Bhawan Jag, Venna Suraj
Washington Hospital Center, Department of Internal Medicine-Dermatology, 110 Irving Street NW, Washington DC 20010, USA.
J Cutan Pathol. 2010 Nov;37(11):1164-7. doi: 10.1111/j.1600-0560.2010.01607.x.
Determining the underlying etiology of recurrent erythema multiforme (EM) can be a difficult endeavor. Although infection with herpes simplex virus (HSV) has been implicated in some cases, the precise trigger of a given patient's recurrent EM often remains elusive. We discuss the case of a woman with a recurrent blistering eruption that was clinically and histopathologically consistent with EM. An investigation into the etiology of the patient's EM suggested that HSV was not the causative factor but instead pointed toward a hormonal influence that we interpret as autoimmune progesterone dermatitis (APD). This case is presented to highlight the importance of considering hormonal triggers in women with recurrent EM that consistently flares during the luteal phase of the menstrual cycle, the point at which serum progesterone levels peak. A brief review of the literature regarding the diagnosis, histopathology, etiology and treatment of APD is further provided.
确定复发性多形红斑（EM）的潜在病因可能是一项艰巨的任务。虽然单纯疱疹病毒（HSV）感染在某些病例中被认为有牵连，但特定患者复发性EM的确切触发因素往往仍难以捉摸。我们讨论了一名患有复发性水疱性皮疹的女性病例，该皮疹在临床和组织病理学上与EM一致。对该患者EM病因的调查表明，HSV不是致病因素，而是指向一种激素影响，我们将其解释为自身免疫性孕酮性皮炎（APD）。介绍该病例是为了强调对于月经周期黄体期（血清孕酮水平达到峰值的时期）反复出现EM的女性，考虑激素触发因素的重要性。此外，还简要回顾了有关APD的诊断、组织病理学、病因和治疗的文献。
