Autoimmune Progesterone Dermatitis is a disease, which is also known by its acronym APD. It comes under the category of skin diseases. It involves a skin rash that appears and doesn’t seem to go away. Even if the rash disappears, it returns eventually. The severity of the skin rash depends on the particular phase of the menstrual cycle. Yes, this disease is connected to the menstrual cycle in women.
During the second phase of the menstrual cycle, a hormone called progesterone rises and eventually comes down once menstruation is over. The progesterone causes an immune reaction in the individual’s body which eventually leads to Autoimmune Progesterone Dermatitis. This is theorized to be the cause of Autoimmune Progesterone Dermatitis.
Autoimmune Progesterone Dermatitis (APD) is a pretty rare disorder. Fertile women are more at risk in APD. Women who have an exogenous intake of progesterone and who are pregnant can also be at risk to APD.
Following are some signs and symptoms of APD:-
- Lesions (eczametous)
- Erythema multiforme
Different kinds of medicines are used for treating APD. Medicines help bring about anovulation, and eventually oophorectomy, especially when the symptoms are difficult to deal with.
Exogenous intake of progesterone is usually in the form of contraceptive pills that are taken orally. What this does is that it causes the body to react to the progesterone that it produces on its own. In women who get APD without the intake of oral contraceptive pills, a different kind of progesterone is produced which elicits the response against it. Progesterone might also be making the body hypersensitive to another allergen present in the body. This theory, however, is yet to be confirmed. Another theory suggests that before the occurrence of APD, the body might just be tolerating and managing the releases of progesterone, however, once the threshold limit is crossed, it might be giving into the APD phase. Symptoms include Angiedema, ulcers and other problems in the mouth, along with itching, which is experienced by all of the women suffering from APD.
Skin issues can happen on any of the following body parts:
- Upper body
- Around the mouth
The treatment for APD is done by testing the skin for allergies. The testing is deemed positive if a particular wheatish patch develops on the skin in a period of 24-48 hours. Even though APD reduces on its won, it returns back every menstrual cycle. Anti-itch medicines can be used for relief. Sometimes, steroids and hormone therapy are used to suppress ovulation and the production of progesterone in the body.
If deciding to deal with alternative treatments, the focus should be on hormonal balance. The second objective would be to restore the functions of the immune system back to their potential, followed by approaching each and every fertility issue in the body.
The guidelines for the diagnosis of APD includes:
- Cyclic cutaneous lesions pertaining to the menstrual cycle
- A positive progesterone skin test or a positive oral/intramuscular challenge to progesterone
- Demonstration of a circulating antibody to the progesterone or basophil degranulation tests
This disease majorly occurs in adult women. Progesterone is linked to proper development during the early stages of pregnancy, along with a link to the body’s internal temperature.
Steroids (corticosteroids) are usually given in mild cases of APD. A problem is that most of the symptoms of APD are pretty generic. As a result, a lot of these cases usually go unnoticed. Therefore, very few cases are reported, with the disease already being so rare among women.
Following are some skin problems that occur during the same period of APD, but are not associated to it:
- Lupus erythematosus
- Nickel allergy
- Dermatitis (Atopic)
- Cold sores
The impact of APD on the succession of conception, is still debatable. As many women are able to conceive, along with APD, while others haven’t been able to produce babies. Treatment should be administered by someone who has an idea about reducing the reactions to progesterone without affecting ovulation in the individual.
In the end, APD affects the quality of a woman’s life, and should be taken care of systematically and safely.