Table 2

Treatment options used in autoimmune progesterone dermatitis

Treatment Option
Advantages
Disadvantages

Oral Contraceptives (OCPs)
- Usually tried as initial therapy
- Limited success due to the progesterone component of OCPs

- Fewer side effects than other most other therapies

Antihistamines
- Well tolerated, few side effects
- Rarely effective as monotherapy


- Does not address underlying mechanism
Conjugated Estrogens
- Avoids progesterone component of OCPs
- Increased risk of endometrial cancer, not commonly used today


- Often require high doses
Glucocorticoids
- Able to suppress multiple components of the immune system
- Usually not effective alone

- Can be combined with other therapies
- Often require high doses
GnRH Agonists
- Often used if OCPs and glucocorticoids are not effective
- Can cause symptoms of estrogen deficiency (hot flashes, decreased bone mineral density)
Alkaylated Steroids
- Can be combined with low dose steroids
- Can cause symptoms of excess androgens (facial hair, hepatic dysfunction, mood disorders)

- Interferes with gonadal hormone receptors

Tamoxifen
- Has been used successfully in patients unresponsive to conjugated estrogen
- Can cause symptoms of estrogen deficiency


- Increased risk of venous thrombosis and cataract formation
Bilateral oopherectomy
- Definitive treatment, used if medical options unsuccessful
- Surgical procedure, associated morbidity


- Symptoms of estrogen deficiency

Baptist and Baldwin Clinical and Molecular Allergy 2004 2:10   doi:10.1186/1476-7961-2-10