Cases reported "Dermatitis"

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1/11. Autoimmune progesterone dermatitis.

    Autoimmune progesterone dermatitis (APD) is an uncommon cutaneous disorder characterized by exacerbations during the luteal phase of the menstrual cycle. We describe a 27-year-old woman with a recurrent skin eruption for 3 years. She had no history of exposure to synthetic progesterones. At each menses, the patient developed scaly, erythematous maculopapular lesions over the face. Intradermal skin test reaction to progesterone was positive. progesterone sensitivity was also demonstrated by challenge test with intramuscular progesterone acetate. These features were consistent with the diagnosis of APD. Our patient was treated successfully with conjugated estrogen for 6 months. At one year follow-up, the patient had had no recurrence of facial eruption.
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keywords = menstrual cycle, cycle
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2/11. Autoimmune progesterone dermatitis.

    Autoimmune progesterone dermatitis is a rare cutaneous disorder characterized by recurrent cyclic eruptions with variable morphology occurring during the luteal phase of the menstrual cycle. We report a case of a 40-year-old woman with recurrent pruritic eruptions of 8 years' duration. The possibility of autoimmune progresterone dermatitis was raised because of the cyclic nature of the exacerbations. We used oral estrogen both to confirm the diagnosis and to treat the patient. A brief review of the clinical features of the disease is also presented.
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keywords = menstrual cycle, cycle
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3/11. Localized hand-foot syndrome after intra-arterial hepatic chemotherapy with floxuridine: a clinical case.

    hand-foot syndrome is a toxic effect of some chemotherapy agents such as 5-fluorouracil (5-FU), capecitabine and liposomal doxorubicin. The symptoms and signs are localized erythema and paresthesia. floxuridine (FUDR) is an analogue of 5-FU, used for arterial hepatic infusion in patients affected by liver metastases from colorectal cancer. A patient who was treated for colorectal cancer with liver metastases underwent locoregional chemotherapy with FUDR and systemic chemotherapy with FOLFOX4. After three cycles he developed severe painful dermatitis of the right leg. Abdominal X-ray showed displacement of the catheter to the right common iliac artery. Treatment was discontinued and the patient had a rapid recovery.
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ranking = 0.0051791112982326
keywords = cycle
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4/11. Autoimmune progesterone dermatitis.

    Autoimmune progesterone dermatitis (APD) is a rare disorder characterized by recurrent polymorphous skin manifestations, which appear or are exacerbated during the luteal phase of the menstrual cycle. The hallmarks for diagnosis include premenstrual flare, its prevention with the inhibition of ovulation, and positive skin reaction to intradermal injection of progesterone. The mainstay of treatment is to inhibit the secretion of endogenous progesterone by suppressing ovulation. Bilateral oophorectomy may be necessary in patients with severe and refractory symptoms. We report herein the case of a 38-year-old woman who developed recurrent and cyclic vesiculobullous eruptions clinically suggestive of erythema multiforme or autoimmune bullous diseases. The skin manifestations turned out to be APD. The patient was treated with tamoxifen 20 mg daily with complete symptom remission after 4 months.
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keywords = menstrual cycle, cycle
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5/11. A case of autoimmune progesterone dermatitis in an adolescent female.

    BACKGROUND: progesterone-induced dermatitis is a rare disorder. It typically occurs in females due to an autoimmune phenomenon to endogenous progesterone production, but can also be caused by exogenous intake of a synthetic progestin. Here, we present a case of autoimmune progesterone dermatitis (AIPD) seen in an adolescent female. CASE: The patient is a 15-year-old Caucasian female with no significant past medical history and no prior exogenous hormone use, who presented to her primary care physician complaining of cyclic skin eruptions. She noted that her dermatologic symptoms occurred monthly, just prior to her menses. An intradermal skin test using 0.1 cc of progesterone was performed. The patient immediately developed a wheal, confirming the diagnosis of AIPD. The patient was begun on a continuous regimen of an oral contraceptive pill with 30 micrograms of ethinyl estradiol and 0.15 mg of levonorgestrel. The skin eruptions have not returned since the initiation of this therapy. CONCLUSION: Autoimmune progesterone dermatitis manifests via the occurrence of cyclic skin eruptions. women with the disorder commonly present with dermatologic lesions in the luteal phase of the menstrual cycle. diagnosis of AIPD is confirmed by performing a skin allergen test using progesterone. Due to its rarity, AIPD should be considered a diagnosis of exclusion. In cases believed to be due to an endogenous production of progesterone, several methods of therapy have been attempted. The ultimate goal of therapy is the suppression of ovulation, which will prevent endogenous hormone production as progesterone is only produced in ovulatory cycles. Currently, the first-line choice of therapy is a combination oral contraceptive. If this treatment is ineffective, patients have been treated with danazol, gonadotropin releasing hormone analogs, tamoxifen, and oophorectomy with varying success.
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ranking = 1.0051791112982
keywords = menstrual cycle, cycle
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6/11. The role of intradermal skin testing and patch testing in the diagnosis of autoimmune progesterone dermatitis.

    Autoimmune progesterone dermatitis is a rare clinical condition in which patients display hypersensitivity to endogenous progesterone. It manifests as a cyclical cutaneous eruption that flares during the luteal phase of the menstrual cycle, when progesterone levels peak, and resolves partially or completely a few days after menses. Its cutaneous manifestations are variable and include urticaria, eczematous eruptions, vesiculopustular eruptions, fixed drug eruptions, stomatitis, erythema multiforme, and anaphylaxis. Autoimmune progesterone dermatitis has been diagnosed previously with intradermal skin testing or intramuscular progesterone challenge. Treatment of progesterone hypersensitivity generally consists of ovulation inhibition with pharmaceutical agents or oophorectomy; other therapies (eg, thalidomide) have also been used with success. We report a case of cyclical erythema multiforme (EM) induced by hypersensitivity to endogenous progesterone in a patient with a history of past oral contraceptive use. After herpes simplex virus was ruled out as an etiologic factor, a diagnosis of progesterone hypersensitivity was confirmed with intradermal skin testing. Results of subsequent patch testing with various progesterone derivatives were negative. The EM outbreaks were suppressed temporarily by continuous administration of Loestrin (ethinyl estradiol plus norethindrone), which also increased the responsiveness of the outbreaks to prednisone tapers.
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keywords = menstrual cycle, cycle
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7/11. Autoimmune progesterone dermatitis.

    hypersensitivity to progesterone is rare, but the occurrence of skin rash in the luteal phase of the menstrual cycle or during pregnancy should alert one to this possibility. The diagnosis can be readily confirmed by intradermal testing and is eminently treatable by ovulation suppression.
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keywords = menstrual cycle, cycle
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8/11. arginine deficiency syndrome. Its occurrence in carbamyl phosphate synthetase deficiency.

    A child with carbamyl phosphate synthetase deficiency was studied. During attempts at dietary control, a peculiar rash and cessation of growth were noted concomitant with a very low serum arginine level. A prospective study was designed so that the only variable would be the addition of 400 mg of arginine to his diet. During the two-week period without arginine, the rash and growth failure recurred and paralleled a drop in the serum arginine level from 0.048 to 0.034 nmol/mL. Then with the addition of arginine, his rash dramatically cleared and he resumed normal growth. Later, it became necessary to raise his arginine intake to 800 mg/day to maintain continued growth. These data support the concept that arginine becomes an "essential" amino acid in persons with urea cycle defects, which may partially explain the extremely variable clinical manifestations and courses seen in these patients.
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ranking = 0.0051791112982326
keywords = cycle
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9/11. Autoimmune progesterone dermatitis.

    Autoimmune progesterone dermatitis is a rare cutaneous disorder characterized by recurrent cyclic eruptions during the luteal phase of the menstrual cycle. We describe a woman with postpartum onset of a papulovesicular eruption. The possibility of autoimmune progesterone dermatitis was raised because of the cyclic nature of the outbreak. A reactive intradermal progesterone test confirmed the diagnosis. A review of individual case reports is also presented.
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keywords = menstrual cycle, cycle
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10/11. Autoimmune progesterone dermatitis: onset in a women without previous exogenous progesterone exposure.

    Autoimmune progesterone dermatitis is a rare clinical entity that may be seen by the family practitioner, gynecologist, or dermatologist. Recognition of the entity is paramount in the therapy of this easily treated condition. We report a case of a 36-year-old woman with a recurrent facial dermatitis of many months' duration. We found the cutaneous eruption to be temporally related to her menstrual cycle. The patient denied any changes in her diet, cosmetics, medications, or soaps that could account for the dermatitis. Despite no previous exposure to exogenous progesterone, the diagnosis of autoimmune progesterone dermatitis was made. The patient was cured by oophorectomy.
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keywords = menstrual cycle, cycle
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