Thank you for your recent inquiry.
For your convenience, I have copied below several abstracts from papers discussing autoimmune progesterone dermatitis. Most of these appear in the dermatology literature, but there is one from the Annals of Allergy which is a review of the literature and report of a case.
The best I could find from reading the papers I had access to is that the testing is done by intradermal tests using 0.01 mg of commercially available progesterone for injection. There may be more than one such product available on the market, but Watson Pharma, Inc. manufactures one preparation.
I think it is important to understand that progesterone is not water soluble. It is soluble in alcohol and acetone, and the preparations that I have found for injection are contained in a vegetable oil, usually sesame oil. Thus, the best I can tell, the preparation described above is the type used in skin testing, and it can be ordered from the pharmacist at any pharmacy you use.
You may find more details about the testing procedure in the articles cited. You should have ready access to at least the Annals article.
Thank you again for your inquiry and we hope this response is helpful to you.
Dermatitis. 2006 Mar;17(1):39-42.
The role of intradermal skin testing and patch testing in the diagnosis of autoimmune progesterone dermatitis.
Stranahan D, Rausch D, Deng A, Gaspari A.
Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD 21201-1734, USA.
Abstract
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.
Eur J Dermatol. 2002 Nov-Dec;12(6):589-91.
Autoimmune progesterone dermatitis.
Oskay T, Kutluay L, Kaptanoğlu A, Karabacak O.
Department of Dermatology, Bayindir Medical Centre Ankara, Mesa Park Sitesi, Sedir Apt. Daire: 44, 06450 Oran/Ankara/Turkey. tubaoskay@hotmail.com
Abstract
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.
J Am Acad Dermatol. 1995 Feb;32(2 Pt 2):333-8.
Autoimmune progesterone dermatitis.
Herzberg AJ, Strohmeyer CR, Cirillo-Hyland VA.
Department of Pathology, East Carolina University, Greenville, North Carolina.
Comment in: J Am Acad Dermatol. 1996 May;34(5 Pt 1):863-4.
Abstract
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.
Autoimmune progesterone dermatitis and its manifestation as anaphylaxis: a case report and literature review.
Joy L. Snyder, Guha Krishnaswamy
Annals of Allergy, Asthma & Immunology
May 2003 (Vol. 90, Issue 5, Pages 469-477
Sincerely,
Phil Lieberman, M.D.