Autoimmune progesterone dermatitis manifesting as generalized fixed drug eruption

Carrasco-Zuber, Juan Eduardo; Álvarez-Véliz, Sergio; Moll-Manzur, Catherina; González-Bombardiere, Sergio

doi:10.1590/abd1806-4841.20187290

Juan Eduardo Carrasco-Zuber Mailing Address: Juan Eduardo Carrasco Zuber . E-mail: juaneduardocarrasco@gmail.com

Centro Médico Los Torreones, Valdivia, Chile.

http://orcid.org/0000-0001-8359-9765

Sergio Álvarez-Véliz

Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

http://orcid.org/0000-0003-2653-0969

Catherina Moll-Manzur

Department of Non-Communicable Diseases, Ministerio de Salud, Chile.

http://orcid.org/0000-0001-6274-7976

Sergio González-Bombardiere

Department of Pathology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

http://orcid.org/0000-0002-2639-9553

Mailing Address: Juan Eduardo Carrasco Zuber . E-mail: juaneduardocarrasco@gmail.com

Conflict of interest: None.

AUTHORS' CONTRIBUTIONS

Juan Eduardo Carrasco-Zuber

0000-0001-8359-9765

Approval of the final version of the manuscript, Conception and planning of the study, Elaboration and writing of the manuscript, Critical review of the literature, Critical review of the manuscript

Sergio Álvarez-Véliz

0000-0003-2653-0969

Approval of the final version of the manuscript, Elaboration and writing of the manuscript, Critical review of the literature, Critical review of the manuscript

Catherina Moll-Manzur

0000-0001-6274-7976

Approval of the final version of the manuscript, Elaboration and writing of the manuscript, Critical review of the literature

Sergio González-Bombardiere

0000-0002-2639-9553

Approval of the final version of the manuscript, Intellectual participation in propaedeutic and/or therapeutic conduct of the cases studied, Critical review of the manuscript

Reference	Age	History	Clinical results	ID with progesterone	Histology	Treatment response
2	21 years.	None.	First 7 months: urticaria and dyspnea. Following intradermal test: erythematous plaque on forearm. Pruritus (+).	Result (+) immediately and disappeared the following day.	No biopsy.	Topical steroids. Regression of lesions with subsequent hyperpigmentation.
3	34 years.	None.	6 months of round, clearly delimited violaceous plaques with vesicles and eschars on left arm. Pruritus (+).	Result (+), which persisted for 48 hrs.	Sub-epidermal vacuolar degeneration with necrotic keratocytes, superficial lymphocytic infiltrates, pigmentary incontinence.	Oral prednisone (40 mg) for a period. Subsequent recurrence with significantly reduced severity.
4	21 years.	Began OCP in the month when skin symptoms began.	3 months of oval violaceous plaques on the neck, face, and perioral zone.	Result (+).	Interface dermatitis associated with a predominantly lymphoid infiltrate and scattered melanocytes (in the presence of corticoids).	Oral prednisone. OCP (35ug ethinyl estradiol + 0.4mg norethindrone). Resolution of lesions.
5	29 years.	None.	Ulcerations on palate and tongue. Erythema on the lips, with vesicles, ulcerations, and signs of exfoliation. Macules on the face, fingers, and shoulder. General malaise (+), mild fever (+), pain (+), burning sensation (+).	Result (-) with 48 hours of evaluation.	Superficial perivascular dermatitis, with spongiosis and pigmentary incontinence. Fontana-Masson stain (+) for melanin in surface dermis between histiocytes and around subcutaneous tissue.	Tamoxifen 20mg/ day for 2 months Alleviation of cutaneous symptoms and slow resolution of hyperpigmentation.
Case at hand	26 years.	Recent miscarriage with curettage and irregular use of OCP.	5 months of clearly demarcated violaceous plaques located at the armpits, groin, labia majora, intergluteal cleft, and abdomen. Pain (+), burning sensation (+), pruritus (+).	Result (+) immediately that persisted for 6 hours	Surface inflammatory reaction with mild perivascular lymphocyte infiltration, some in the papillae, vacuolar alteration and numerous melano- phages, with sparse eosinophils.	OCP (2ug dieno- gest + 0.03mg ethinyl estradiol) + oral antihistamines. Resolution of lesions. No recurrence in 5 months of follow-up.

[1] Mailing Address: Juan Eduardo Carrasco Zuber . E-mail: juaneduardocarrasco@gmail.com

Brasil

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Autoimmune progesterone dermatitis manifesting as generalized fixed drug eruption^* * Work conducted at the Centro Médico Los Torreones, Valdivia, Chile.

Abstract:

Brasil

Brasil

Autoimmune progesterone dermatitis manifesting as generalized fixed drug eruption* * Work conducted at the Centro Médico Los Torreones, Valdivia, Chile.

Abstract:

Autoimmune progesterone dermatitis manifesting as generalized fixed drug eruption^* * Work conducted at the Centro Médico Los Torreones, Valdivia, Chile.