Autoimmune Progesterone Dermatitis

Tami Maguire

Disclosures

Dermatology Nursing. 2009;21(4):190-192. 

In This Article

Pathogenesis

The exact pathogenesis of autoimmune progesterone dermatitis is unknown. In cases with prolonged progesterone therapy (oral contraceptives), it is conceivable that uptake by antigen-presenting cells and presentation to T-helper cells could result in IgE synthesis. Although this would not explain the onset of symptoms in patients who have not had prior exogenous progesterone exposure and have APD (Cristaudo et al., 2007). Progesterone also has been reported to have a direct histaminereleasing effect on mast cells, but not much research has been done to support this hypothesis. Antibodies against progesterone have been investigated using immunofluorescent techniques and basophil degranulation tests. These studies found that such antibodies do exist in certain patients with APD (Baptist & Baldwin, 2004). However, negative results have also been reported.

Another theory could be that a patient might be able to tolerate low levels of her own progesterone, but as the level of progesterone rises during the menstrual cycle or pregnancy, it may reach critical levels and the woman's body reacts against it (Snyder & Krishnaswamy, 2003).

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