Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Allergy Asthma Immunol Res. 2011 Apr;3(2):141-4. doi: 10.4168/aair.2011.3.2.141. Epub 2011 Feb 9.
Autoimmune progesterone dermatitis is a rare autoimmune response to endogenous progesterone that usually occurs in fertile females. Cutaneous or mucosal lesions develop cyclically during the luteal phase of the menstrual cycle when progesterone levels are elevated. Symptoms usually start 3-10 days before menstruation and resolve 1-2 days after menstruation ceases. We report the case of a 48-year-old woman with intermittent eczematous skin lesions of the legs, forearms, and buttocks. She was diagnosed with allergic contact dermatitis, and topical steroids were prescribed. Her skin eruptions waxed and waned for 6 years and were associated with her menstrual cycle. We performed an intradermal test using progesterone, which was positive, and prescribed gonadotropin-releasing hormone analogues monthly for 3 months. The patient's skin lesions improved, confirming the diagnosis. Autoimmune progesterone dermatitis should be included in the differential diagnosis of recurrent eczema that is refractory to treatment in women of child-bearing age.
自身免疫性孕激素性皮炎是一种罕见的针对内源性孕激素的自身免疫反应,通常发生在生育期女性中。当孕激素水平升高时,在月经周期的黄体期,皮肤或黏膜病变会呈周期性出现。症状通常在月经前 3-10 天开始,在月经停止后 1-2 天消退。我们报告了一例 48 岁女性间歇性腿部、前臂和臀部湿疹样皮损。她被诊断为过敏性接触性皮炎,给予了外用类固醇治疗。她的皮肤病变时好时坏持续了 6 年,并与她的月经周期有关。我们对孕激素进行了皮内试验,结果阳性,并开具了促性腺激素释放激素类似物,每月 1 次,共 3 个月。患者的皮肤病变改善,确诊了该疾病。对于生育年龄女性中治疗抵抗的复发性湿疹,应将自身免疫性孕激素性皮炎纳入鉴别诊断。