Monday, August 13, 2012

Autoimmune Progesterone Dermatitis

I'm starting to get more answers than questions, which is something that makes me VERY happy.  I actually am able to see the allergist on Thursday after they discussed me today (versus late October, which was initially the "first appointment" they had open).  Apparently, I piqued their interest enough to get me in the door quickly.  Diagnose and treat me, please!

With my well-earned MD using Dr. Google as my tenured professor, I am about 99% certain of what I have:

Autoimmune Progesterone Dermatitis

Sounds kind of scary and awful, right?  In reality, it might not be that bad.  And something identifiable can be treated, so that's pretty great.   The allergist will need to either do a skin flap test or an antibody test to ultimately confirm my ailment, but I'm pretty positive that we'll be able to move on pretty quickly to treatment once that occurs.

Some key points from Dr. Google:

-Autoimmune progesterone dermatitis (APD) occurs as a result of an allergic reaction to a woman's own progesterone.

-APD may be caused initially by a woman taking birth control pills or another hormone supplement containing progesterone that results in sensitization to the hormone.  Like progesterone in oil shots!!!!

-APD can have a variety of different symptoms, although most, if not all, include skin rashes.  I am feeling my itchy feet and the breakouts on the rest of my body right now!

-Symptoms typically occur anywhere from 3 to 10 days prior to the onset of menses, and begin to resolve within 1 to 2 days after the onset of menstruation.  Mine have almost always started at 3 days past ovulation (about 10 days prior to my period) and clear up by my period.

And the good news:

-Treatment of APD may be successful with the use of antihistamines and oral or injected corticosteroids

And the BEST news:

-The cells responsible for this are the CD 19+5+ cells. By 10 weeks of pregnancy these cells are usually suppressed to normal numbers and the progesterone allergy is less of a problem.

One thing to note is, as with any condition, there is a wide spectrum of how the symptoms show themselves.  My itchiness seems to be at the more minor end.  Some people can go into anaphylatic shock due to their allergy and ultimately must have their ovaries removed as the only treatment.  I am VERY thankful I do not appear to be in that category and my heart goes out to the people that are.

So I'll update on here what the ultimate result and treatment was, especially for those poor folks that have been googling "progesterone allergy and pregnancy" in panic for days on end, and stumbled across this post.  It sounds like there is a light at the end of the tunnel, and hopefully this is just one more hurdle that we can conquer!

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