Hormones and Hives

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Still trying to catch up on my e-mail. For all of you who have questions about whether hives can be related to female hormones, I'm posting the following. Love, Myra

===============================================================J Am Acad Dermatol 1995 Jan;32(1):25-31Estrogen dermatitis. WB, ED, Talanin NY, Santoso-Pham JDepartment of Medicine, Medical College of Ohio, Toledo 43699.BACKGROUND: Autoimmune progesterone dermatitis includes pruritus (burning and itching without hives) , urticaria,papulovesicular eruptions, and bullous erythema multiforme. Sensitivity toestrogen has not been described, although it was probably first recognizedalmost 50 years ago. OBJECTIVE: Our purpose was to assess sensitization toselected hormones in women with a significant premenstrual flare of skinlesions. METHODS: Intradermal skin tests to 18 hormones and controlsubstances were performed in seven patients and four control subjects andread for immediate urticarial and delayed type reactions. Six other controlsubjects had only estrone and progesterone skin tests. The effect of theantiestrogen tamoxifen on the course of the dermatosis was studied. RESULTS:Seven women exhibiting severe premenstrual exacerbations of papulovesiculareruptions, urticaria, eczema, or generalized pruritus proved to have anunrecognized sensitivity to estrogen. Five patients had a positive delayedtuberculin-type skin test to estrogen. Two patients with generalized chronicurticaria had only an urticarial reaction to intradermal estrogens.Antiestrogen therapy with tamoxifen proved effective in all five patients,whereas elimination of oral estrogen therapy cured the other two patients.CONCLUSION: Women can become sensitized to their own estrogens; the majorclue is worsening of the skin problem premenstrually. Positive intradermalskin tests to estrogens are diagnostic. Tamoxifen is a specific therapy. Wehave named this disorder estrogen dermatitis.Publication Types:ReviewReview literaturePMID: 7822514, UI: 95122767==============================================================Eur J Obstet Gynecol Reprod Biol 1997 Mar;72(1):97-103Estrogen dermatitis.Leylek OA, Unlu S, Ozturkcan S, Cetin A, Sahin M, Yildiz EDepartment of Obstetrics and Gynecology, Cumhuriyet University, School ofMedicine, Kadin Hastaliklari Anabilim Dali, Sivas, Turkey.The aim of the present study was to evaluate the estrogen dermatitis ofwomen who have chronic skin disorders with exacerbations or premenstrualdermatitis in a cyclic pattern. Twenty-three women exhibiting skin disordersof pruritus, urticaria, eczema, papulovesicular eruption, hirsutism-acnewith hyperpigmentation (hirsutism and/or its related disorders such as acne)and 18 healthy control subjects were included in the study. Sensitivity toestrogen was described in 14 of 23 women. Of the 14 estrogen sensitivewomen, nine had a premenstrual flare of their skin lesions and five had achronic dermatitis with exacerbations. In the evaluation of endocrineprofile, mean serum testosterone and LH levels of the patient group weresignificantly higher than controls (2.814 +/- 0.839 vs. 1.561 +/- 0.645nm/l, P < 0.001; 10.843 +/- 2.538 vs. 4.539 +/- 1.215 IU/l, P < 0.0001). TheLH/FSH ratio of the patient group was also significantly higher thancontrols (1.765 +/- 0.329 vs. 0.810 +/- 0.0116, P < 0.0001). Mean serumprogesterone level of the patient group was significantly lower than thecontrol group (0.499 +/- 0.201 vs. 0.977 +/- 0.396 ng/ml, P < 0.001).Hyperandrogenism and anovulation were the two more common outcomes in thepatient group. Skin lesions of estrogen sensitive women were all cured withthe administration of tamoxifen 20 mg daily for 7 days premenstrually.PMID: 9076430, UI: 97231034==========================================================Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998 May;85(5):537-41Autoimmune progesterone dermatitis and stomatitis.Moghadam BK, Hersini S, Barker BFDepartment of Diagnostic Sciences, University of Missouri-Kansas City Schoolof Dentistry, 64108, USA.

Autoimmune progesterone dermatitis is a rare clinical condition associatedwith variable cutaneous and mucosal eruptions such as urticaria, erythemamultiforme, and eczema. Exacerbation is influenced by hormonal changes ofthe menstrual cycle. The patient described in this report had recurrentcyclic lesions on the skin, oral mucosa, and lips that appeared just beforeregular menstruation and persisted until a few days after. During eachcycle, the eruptions appeared at the previously affected sites, mimickingthe clinical feature of a fixed drug eruption. This rare phenomenon isattributed to an autoimmune reaction to female sex hormones. The conditionfailed to respond to therapy with prednisone, but improved with the use ofan antiestrogen drug, tamoxifen. This medication suppresses ovulation andthe post-ovulation rise in endogenous progesterone levels.PMID: 9619670, UI: 98280969=============================================================

Am J Reprod Immunol 1999 Jan;41(1):34-40

Decidual mast cells might be involved in the onset of human first-trimesterabortion.Marx L, Arck P, Kieslich C, Mitterlechner S, Kapp M, Dietl JDepartment of Obstetrics and Gynecology, Julius-Maximilians University,Wurzburg, Germany.PROBLEM: The aim of the present study was to identify the role of mast cellsand substance P (SP)-containing nerve fibers in human decidua in normal andpathological pregnancies. METHOD OF STUDY: We collected decidua from womenundergoing termination of normal pregnancies and from abortions. Thepresence of mast cells and SP was detected by immunohistochemistry. RESULTS:We observed a sparse distribution of mast cells in the normal pregnancies(36.7 tryptase+ mast cells/mm2 decidua). In the decidua from abortion, wefound a dramatic increase in the number of mast cells (448.7 and 469.2tryptase+ mast cells/mm2 decidua in primary and secondary abortions,respectively). In addition, we observed an increase of SP-positive nervefibers in the decidua of abortions. CONCLUSIONS: Our data suggest thatdecidual mast cells may play an important role in the onset of abortion, dueto the production of cytokines, such as tumor necrosis factor-alpha.PMID: 10097785, UI: 99197858