Moghadam B K, Hersini S, Barker B F
Department of Diagnostic Sciences, University of Missouri-Kansas City School of Dentistry, 64108, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998 May;85(5):537-41. doi: 10.1016/s1079-2104(98)90287-6.
Autoimmune progesterone dermatitis is a rare clinical condition associated with variable cutaneous and mucosal eruptions such as urticaria, erythema multiforme, and eczema. Exacerbation is influenced by hormonal changes of the menstrual cycle. The patient described in this report had recurrent cyclic lesions on the skin, oral mucosa, and lips that appeared just before regular menstruation and persisted until a few days after. During each cycle, the eruptions appeared at the previously affected sites, mimicking the clinical feature of a fixed drug eruption. This rare phenomenon is attributed to an autoimmune reaction to female sex hormones. The condition failed to respond to therapy with prednisone, but improved with the use of an antiestrogen drug, tamoxifen. This medication suppresses ovulation and the post-ovulation rise in endogenous progesterone levels.
自身免疫性孕酮性皮炎是一种罕见的临床病症,与多种皮肤和黏膜疹有关,如荨麻疹、多形红斑和湿疹。病情加重受月经周期激素变化影响。本报告中描述的患者在皮肤、口腔黏膜和嘴唇上出现反复发作的周期性病变,恰好在正常月经前出现并持续至月经后几天。在每个周期中,皮疹出现在先前受累部位,酷似固定性药疹的临床特征。这种罕见现象归因于对女性性激素的自身免疫反应。该病症对泼尼松治疗无反应,但使用抗雌激素药物他莫昔芬后病情改善。这种药物可抑制排卵以及排卵后内源性孕酮水平的升高。