Gonadotropin-releasing hormone agonist use to guide diagnosis and treatment of autoimmune progesterone dermatitis. Obstet Gynecol 2015 May;125(5):1114-1116
Date
02/25/2015Pubmed ID
25710617DOI
10.1097/AOG.0000000000000569Scopus ID
2-s2.0-84928137336 (requires institutional sign-in at Scopus site) 10 CitationsAbstract
BACKGROUND: 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.
CASE: 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.
CONCLUSION: 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.
Author List
Domeyer-Klenske A, Robillard D, Pulvino J, Spratt DMESH terms used to index this publication - Major topics in bold
Autoimmune DiseasesDelayed-Action Preparations
Dermatitis
Female
Gonadotropin-Releasing Hormone
Humans
Injections, Intramuscular
Leuprolide
Luteal Phase
Middle Aged
Progesterone
