Cases reported "Dermatitis"

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1/5. Oestrogen dermatitis.

    A 56-year-old woman presented with a recurrent itchy eruption mainly involving her face and upper trunk for 5 years. The rash flared cyclically 3 days before her menstruation and improved 5-10 days after the onset of her period. Examination revealed erythematous maculopapules, vesicles and crusting mainly on her face and upper trunk. biopsy from a papule revealed spongiotic dermatitis. Intradermal testing with oestrogen was positive. There was marked improvement with tamoxifen. Sensitivity to oestrogen and progesterone is rare in women and the clinical presentation may be similar. Positive intradermal testing is diagnostic. tamoxifen is effective in treating oestrogen sensitivity.
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keywords = menstruation
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2/5. Estrogen dermatitis that appeared twice in each menstrual period.

    A 23-year-old woman presented with millet-sized red papules that were scattered over her chest and abdomen. She stated that since the age of 20, she had recurrently suffered from pruritic eruptions that coincided with ovulation and the time prior to menstruation, and that they persisted for a few days before vanishing spontaneously leaving some pigmentation. A skin biopsy specimen revealed spongiotic bullae in the epidermis and marked infiltration of lymphocytes accompanied by some histiocytes and eosinophils in the upper dermis. An intradermal test for conjugated estrogen showed an urticarial reaction that faded in about four hours. Although the test did not strictly meet the criterion (erythema to remain for more than 24 hours for papulovesicular eruptions), it was concluded that the timing of the episodes along with the result of the test suggested that a diagnosis of estrogen dermatitis was highly probable. There have been several reports of this condition since it was first reported as a distinct entity in 1995; but whatever the reasons, the flares were observed only before menstruation in these cases, despite the fact that the serum estrogen levels showed a double-peaked pattern during each menstrual period. This is considered to be a rare case of estrogen dermatitis that flared twice in each menstrual period. Limited improvement was noted in the symptoms even without treatment.
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keywords = menstruation
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3/5. Autoimmune progesterone dermatitis.

    A 35-year-old woman had recurrent urticarial erythemas on her trunk and extremities for 3 years. The eruptions appeared regularly 3 to 5 days prior to menstruation and persisted for several days. The patient showed a positive skin test response to progesterone and had circulating antiprogesterone IgG antibodies. A speculative concept of the possible autoimmune damage to the ovary, the major organ producing progesterone, is discussed.
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ranking = 1
keywords = menstruation
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4/5. Two cases of autoimmune progesterone dermatitis. Immunohistochemical and serological studies.

    Two cases of autoimmune progesterone dermatitis are reported. The patients developed recurrent pruritic erythematous and edematous eruptions on the extremities, trunk or face, with occasional vesicles on the palms and soles. The eruptions appeared 7 to 10 days prior to their menstruation and persisted for several days. They showed immediately positive skin tests with 0.1 mg/ml and 0.2 mg/ml of aqueous progesterone suspension, respectively. The patients had IgG serum factor which bound rat corpus luteum. Positive indirect basophil degranulation tests against progesterone were demonstrated in both patients. Circulating autoantibodies to patients' own progesterone may cause or modulate the intermittent eruptions of the disease.
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ranking = 1
keywords = menstruation
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5/5. Autoimmune progesterone dermatitis and stomatitis.

    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.
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ranking = 1
keywords = menstruation
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