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Treatment options used in autoimmune progesterone dermatitis |
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| Treatment Option |
Advantages |
Disadvantages |
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| 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 |
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| Antihistamines |
- Well tolerated, few side effects |
- Rarely effective as monotherapy |
| - Does not address underlying mechanism |
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| Conjugated Estrogens |
- Avoids progesterone component of OCPs |
- Increased risk of endometrial cancer, not commonly used today |
| - Often require high doses |
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| Glucocorticoids |
- Able to suppress multiple components of the immune system |
- Usually not effective alone |
| - Can be combined with other therapies |
- Often require high doses |
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| 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 |
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| 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 |
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| Bilateral oopherectomy |
- Definitive treatment, used if medical options unsuccessful |
- Surgical procedure, associated morbidity |
| - Symptoms of estrogen deficiency |
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Baptist and Baldwin Clinical and Molecular Allergy 2004 2:10 doi:10.1186/1476-7961-2-10 |
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