leuprolide and Dermatitis

Autoimmune estrogen dermatitis is a cyclical cutaneous eruption that occurs premenstrually and goes to the rapid resolution within a few days of menstrual cycles. The disorder has variable clinical manifestations consisting of macules, papules, vesicles, urticarial lesions, bullae, eczematous plaques, and erythema multiforme-like lesions. Herein, we present a case of a 30-year-old woman with attacks of edema and erosions involving the oral and genital mucosal sites on every first day of her menstruation period. She had also multiple endocrinological problems such as hypotroidism and infertility. To determine the sex hormon sensitivity, intradermal skin tests were performed. Based on her personal history and skin test findings, a diagnosis of autoimmune estrogen dermatitis was made. After the oophorectomy, she was free from the skin and mucosal symptoms. We propose that it is important to suspect the diagnosis of autoimmune estrogen dermatitis in patients who present with recurrent cylic eruptions and it must be kept in mind that these patients might have a concomitant infertility.

Topics: Adult; Autoimmune Diseases; Biopsy; Dermatitis; Estrogen Antagonists; Estrogens; Female; Gonadotropin-Releasing Hormone; Humans; Hypothyroidism; Infertility; Leuprolide; Menstrual Cycle; Mouth Mucosa; Ovariectomy; Pain; Pruritus; Skin; Skin Tests; Tamoxifen

Autoimmune progesterone dermatitis is a catamenial disorder traditionally diagnosed by subcutaneous or intramuscular progesterone challenge. Little has been reported regarding the use of a gonadotropin-releasing hormone (GnRH) agonist with a progestin add-back challenge to diagnose and guide management of this condition.. A 50-year-old premenopausal woman presented with cyclic facial rash minimally responsive to standard treatment. Symptoms improved with depot leuprolide acetate and worsened with add-back progesterone therapy. Hysterectomy and oophorectomy were performed with resolution of symptoms. This surgery eliminated endogenous progesterone and permitted estrogen replacement to treat vasomotor symptoms experienced with GnRH agonist therapy.. This case of autoimmune progesterone dermatitis exemplifies the utility of GnRH agonists with a steroid add-back challenge for diagnosing catamenial disorders and guiding treatment.

Topics: Autoimmune Diseases; Delayed-Action Preparations; Dermatitis; Female; Gonadotropin-Releasing Hormone; Humans; Injections, Intramuscular; Leuprolide; Luteal Phase; Middle Aged; Progesterone

Topics: Allergens; Dermatitis; Estrogens; Female; Follow-Up Studies; Humans; Leuprolide; Middle Aged; Patch Tests; Periodicity; Premenstrual Syndrome; Rare Diseases; Risk Assessment; Severity of Illness Index; Treatment Outcome