Case of autoimmune progesterone dermatitis presenting as necrotic migratory erythema successfully controlled by danazol

J Dermatol. 2020 Feb;47(2):178-180. doi: 10.1111/1346-8138.15180. Epub 2019 Dec 12.

Abstract

Autoimmune progesterone dermatitis (APD) is a rare cutaneous disorder with cyclic skin eruptions during the luteal phase of the menstrual cycle. Patients can present with various clinical manifestations, including urticaria and angioedema, erythema multiforme, eczema, fixed drug eruption and centrifugal erythema annulare. In our case, however, the patient's skin lesions mimic necrotic migratory erythema (NME) which is most commonly associated with glucagonoma and rarely with liver disease, inflammatory bowel disease, malnutrition and other tumors. To our knowledge, this is the first case of NME-like APD and is successfully controlled by danazol. This also sheds lights on the etiologic diversity of NME.

Keywords: autoimmune progesterone dermatitis; cyclic aggravation; danazol; menstrual cycle; necrotic migratory erythema.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Autoimmune Diseases / complications
  • Autoimmune Diseases / diagnosis*
  • Autoimmune Diseases / drug therapy
  • Autoimmune Diseases / immunology
  • Danazol / therapeutic use*
  • Dermatitis / complications
  • Dermatitis / diagnosis*
  • Dermatitis / drug therapy
  • Dermatitis / immunology
  • Diagnosis, Differential
  • Estrogen Antagonists / therapeutic use*
  • Female
  • Glucagonoma / complications
  • Glucagonoma / diagnosis
  • Humans
  • Necrolytic Migratory Erythema / diagnosis*
  • Necrolytic Migratory Erythema / drug therapy
  • Necrolytic Migratory Erythema / immunology
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / diagnosis
  • Progesterone / adverse effects*
  • Progesterone / immunology
  • Skin / immunology
  • Skin / pathology
  • Skin Tests
  • Treatment Outcome

Substances

  • Estrogen Antagonists
  • Progesterone
  • Danazol

Supplementary concepts

  • Autoimmune progesterone dermatitis