Autoimmune progesterone dermatitis in the adolescent populat
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Autoimmune progesterone dermatitis (APD) is a rare autoimmune hypersensitivity reaction that occurs cyclically at the peak of endogenous progesterone production during the menstrual cycle in women. A retrospective, single-center, review of all adolescent and pediatric patients (less than 20 years old at onset) with documented diagnosis of APD was done. 17 adolescent APD patients were included (mean age at diagnosis: 14.4 ± 2 years, mean interval of 13.6 ± 11.1 months between symptom onset and diagnosis).

Results:
--12 patients presented with urticaria, 2 with fixed drug eruption.
--Erythema multiforme, eczema, and recurrent aphthous stomatitis were present in 1 patient each.
--Exposure to exogenous progestin was present in 2 patients prior to disease onset.
Progesterone skin test was performed in 6 patients with positive results in 2.

14 patients received antihistamines and/or a topical corticosteroid. Combined oral contraceptives (COCs) were given to 11 patients, in 7 via continuous daily dosing. Gonadotropin-releasing hormone agonist (GnRHa) was used in 5, progesterone desensitization in 4, omalizumab in 2, and danazol in 1 patient.

It was concluded that adolescent APD is associated with a significant delay in diagnosis. The most common manifestation is urticaria. Exogenous exposure to progestins is uncommon in adolescent APD. Continuous COC, GnRHa, and progesterone desensitization have been used to control symptoms.

Source: https://onlinelibrary.wiley.com/doi/full/10.1111/pde.14423
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