Case and Research Letters
Progesterone Autoimmune Dermatitis Responding to Ulipristal Acetate
Respuesta de la dermatitis autoinmune por progesterona al acetato de ulipristal
Leído
9403
Vecesse ha leído el artículo
2366
Total PDF
7037
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S1578219018304153" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.11.017" "estado" => "S300" "fechaPublicacion" => "2019-01-01" "aid" => "1926" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2018" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2019;110:78-81" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4 "formatos" => array:2 [ "HTML" => 2 "PDF" => 2 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731018300887" "issn" => "00017310" "doi" => "10.1016/j.ad.2017.11.016" "estado" => "S300" "fechaPublicacion" => "2019-01-01" "aid" => "1926" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2019;110:78-81" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 598 "formatos" => array:2 [ "HTML" => 181 "PDF" => 417 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">CARTA CIENTÍFICO-CLÍNICA</span>" "titulo" => "Respuesta de la dermatitis autoinmune por progesterona al acetato de ulipristal" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "78" "paginaFinal" => "81" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Progesterone Autoimmune Dermatitis Responding to Ulipristal Acetate" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1822 "Ancho" => 1200 "Tamanyo" => 231816 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Placa eritematoso-edematosa, dolorosa e infiltrada al tacto, de unos 10 cm de diámetro, en antebrazo derecho (A). Prueba epicutánea con progesterona, negativa a las 96 h: Norlevo® en vaselina y Progeffik® en contacto directo con el área de la lesión y sobre piel sana (B).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Oscoz-Jaime, M. Larrea-García, M.J. Mitxelena-Eceiza, N. Abián-Franco" "autores" => array:4 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Oscoz-Jaime" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Larrea-García" ] 2 => array:2 [ "nombre" => "M.J." "apellidos" => "Mitxelena-Eceiza" ] 3 => array:2 [ "nombre" => "N." "apellidos" => "Abián-Franco" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219018304153" "doi" => "10.1016/j.adengl.2018.11.017" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018304153?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731018300887?idApp=UINPBA000044" "url" => "/00017310/0000011000000001/v1_201901030610/S0001731018300887/v1_201901030610/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219018301914" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.05.030" "estado" => "S300" "fechaPublicacion" => "2019-01-01" "aid" => "1943" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2019;110:81-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 8 "formatos" => array:2 [ "HTML" => 7 "PDF" => 1 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Dilated Cardiomyopathy in a Child with Recessive Dystrophic Epidermolysis Bullosa" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "81" "paginaFinal" => "83" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Miocardiopatía dilatada en una niña con epidermólisis ampollar distrófica recesiva" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1275 "Ancho" => 850 "Tamanyo" => 131638 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">generalized erosions on her trunk.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Imbernón-Moya, R. Maseda-Pedrero, M. Feito, R. de Lucas" "autores" => array:4 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Imbernón-Moya" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Maseda-Pedrero" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Feito" ] 3 => array:2 [ "nombre" => "R." "apellidos" => "de Lucas" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731018301571" "doi" => "10.1016/j.ad.2017.10.025" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731018301571?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018301914?idApp=UINPBA000044" "url" => "/15782190/0000011000000001/v1_201901030631/S1578219018301914/v1_201901030631/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219018304128" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.11.014" "estado" => "S300" "fechaPublicacion" => "2019-01-01" "aid" => "1903" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2019;110:76-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2 "HTML" => 2 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Allergic Contact Dermatitis Due to Chlorhexidine in 2 Pediatric Patient" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "76" "paginaFinal" => "77" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Dermatitis alérgica de contacto a clorhexidina en dos pacientes pediátricos" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1088 "Ancho" => 800 "Tamanyo" => 101767 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Exudative, vesicular lesions on the knee (Patient 1).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Córdoba, T. Sanz-Sánchez, E. Mohedano-Vicente, J. Borbujo" "autores" => array:4 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Córdoba" ] 1 => array:2 [ "nombre" => "T." "apellidos" => "Sanz-Sánchez" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Mohedano-Vicente" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Borbujo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731018300577" "doi" => "10.1016/j.ad.2017.10.018" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731018300577?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018304128?idApp=UINPBA000044" "url" => "/15782190/0000011000000001/v1_201901030631/S1578219018304128/v1_201901030631/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Progesterone Autoimmune Dermatitis Responding to Ulipristal Acetate" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "78" "paginaFinal" => "81" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "S. Oscoz-Jaime, M. Larrea-García, M.J. Mitxelena-Eceiza, N. Abián-Franco" "autores" => array:4 [ 0 => array:4 [ "nombre" => "S." "apellidos" => "Oscoz-Jaime" "email" => array:1 [ 0 => "saioaoscoz@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Larrea-García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "M.J." "apellidos" => "Mitxelena-Eceiza" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "N." "apellidos" => "Abián-Franco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Ginecología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Respuesta de la dermatitis autoinmune por progesterona al acetato de ulipristal" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1822 "Ancho" => 1200 "Tamanyo" => 232392 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Erythematous, edematous plaque on the right forearm that is tender and infiltrated to touch measuring some 10<span class="elsevierStyleHsp" style=""></span>cm in diameter. Patch test with progesterone, which was negative at 96<span class="elsevierStyleHsp" style=""></span>hours, and with NorLevo in petrolatum and Progeffik applied directly on the area of the lesion and on healthy skin (B).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Catamenial dermatitis is a rare disease that presents clinically as monthly flares of variable lesions on the skin caused by the hormonal fluctuations of the menstrual cycle.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 46-year-old woman presented with monthly flares of a lesion on her right forearm that first appeared in 2013. An intrauterine device (Mirena, Bayer Hispania SL) inserted in 2011 had been removed some months earlier. She was a smoker and occasionally took ibuprofen, although never for dysmenorrhea. The patient reported that the lesion appeared 3-4 days before menstruation, with spontaneous resolution on days 4-5 of her menstrual cycle.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Physical examination revealed the presence of a tender erythematous, edematous plaque measuring some 10<span class="elsevierStyleHsp" style=""></span>cm in diameter on the right forearm (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Patch testing was performed with the standard series of the Spanish Contact Dermatitis and Skin Allergy Research Group (Grupo Español en Investigación de Dermatitis de Contacto y Alergia Cutánea [GEIDAC]), with progesterone, and with NorLevo (Laboratoire HRA-Pharma) in petrolatum, and Progeffik (Laboratorios Effik) applied directly on the area of the lesion and on healthy skin (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). The results were negative both at 48<span class="elsevierStyleHsp" style=""></span>hours and at 96<span class="elsevierStyleHsp" style=""></span>hours, as was intradermal skin testing, which was performed with progesterone (Carborprot, Pfizer) and read 15<span class="elsevierStyleHsp" style=""></span>minutes and 96<span class="elsevierStyleHsp" style=""></span>hours after infiltration. Biopsy confirmed the presence of a dense interstitial lymphohistiocytic infiltrate and mucin between collagen bands in the dermis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a> A and B).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Both before and during the outbreak, the patient received nonsteroidal antiinflammatory drugs and topical and oral corticosteroids, with partial resolution of symptoms but no prevention of flare-ups during the following months. She subsequently started treatment with Progeffik 300<span class="elsevierStyleHsp" style=""></span>mg/d for 1 month. The lesion remained unchanged during this period, thus leading to a diagnosis of autoimmune progesterone dermatitis. At this point, the patient began treatment off-label with ulipristal acetate (Esmya, Gedeon Richter Iberica) 5<span class="elsevierStyleHsp" style=""></span>mg/d over periods of 3 months with rest periods every 1-2 months. The skin lesions resolved completely during treatment. She has been receiving treatment with ulipristal acetate for 9 months. After the 12th month of treatment, the drug will be stopped, and a wait-and-see approach will be adopted until the patient reaches the menopause.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Autoimmune progesterone dermatitis is a catamenial dermatosis characterized by the appearance of premenstrual skin lesions owing to increased progesterone levels during the luteal phase of the menstrual cycle.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The etiology and pathogenesis of the disease remain unknown, probably because of the low number of cases reported to date (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Nevertheless, antiprogesterone antibodies are thought to be produced as a result of sensitization to progesterone. The antibodies trigger clinical manifestations, since ovulation induces an increase in progesterone during the luteal phase.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,2</span></a> A history of exposure to systemic contraceptives has been reported in up to 66% of cases.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Thus, it is thought that exposure could lead to sensitization to exogenous hormones and triggering of symptoms as the result of a cross-reaction with endogenous progesterone.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> In the remaining 33% of cases, there was no previous exposure to exogenous hormones, and other pathologic autoimmune mechanisms against endogenous progesterone (eg, pregnancy and menarche)<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–4</span></a> are thought to be responsible.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">The clinical presentation of autoimmune progesterone dermatitis is indeed very diverse. There have been reports of cases compatible with Steven-Johnson syndrome, erythema multiforme, dermatitis herpetiformis, eczema, urticaria, stomatitis, petechiae,<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> or, rarely, fixed drug eruption,<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3,5,6</span></a> as in the present case. Symptoms usually appear 3-10 days before menstruation and resolve 5-10 days after the onset of menstruation, coinciding with the fall in progesterone levels.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,7</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">No criteria have been established for confirming a diagnosis of autoimmune progesterone dermatitis,<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,8</span></a> although most authors propose 3<span class="elsevierStyleHsp" style=""></span>criteria:</p><p id="par0045" class="elsevierStylePara elsevierViewall">Cyclical symptoms: onset some days before menstruation (3-10 days) and spontaneous resolution after menstruation.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Interruption of flare-ups with treatments that inhibit ovulation or increases in progesterone levels.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Triggering of symptoms by tests of sensitization to progesterone (contact allergy tests,<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> intradermal tests,<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,3,9</span></a> oral challenge tests,<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,9</span></a> intramuscular tests,<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,3</span></a> and vaginal tests with progesterone<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a>) or confirmation of circulating antiprogesterone antibodies.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">The objective of treatment is to inhibit ovulation in order to block the mechanisms that cause high levels of progesterone during the second phase of the cycle. Today, oral contraceptives are the first-line treatment option. In any case, depending on the age and clinical characteristics of the patient, other drugs can also be used (eg, conjugated estrogens, gonadotropin-releasing hormone analogs, tamoxifen, and danazol). Bilateral oophorectomy can be performed in severe and refractory cases.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> Ulipristal acetate is a progesterone receptor antagonist that acts on progesterone levels. It is thought to inhibit ovulation by blocking both expression of progesterone-dependent genes and peaks of luteinizing hormone.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> Given the patient's age and the fact that she was a smoker, we opted for treatment with ulipristal acetate as a valid alternative.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Autoimmune progesterone dermatitis is an extremely rare skin disease if we take into account the number of women who are treated with oral contraceptives throughout the world. This observation is relevant, since the incidence of the condition is expected to increase in women as a consequence of increased use of oral contraceptives. The present case is the third to date published by Spanish authors<span class="elsevierStyleSup">4,7</span> and the first case of autoimmune progesterone dermatitis treated effectively with ulipristal acetate. We propose ulipristal acetate as an effective therapeutic option in selected cases.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Note</span><p id="par0075" class="elsevierStylePara elsevierViewall">As of February 9, 2018 (after treatment was started in the present case), the Agencia Española de Medicamentos y Productos Sanitarios (Spanish Agency of Medicines and Medical Devices) published the following alarm: “After the notification of severe cases of liver injury in women treated with Esmya, provisional measures have been taken while a detailed analysis of all the available information is being completed. Therefore, as precautionary measures, liver function should be monitored, and no new treatment should be started”.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Note" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Oscoz-Jaime S, Larrea-García M, Mitxelena-Eceiza MJ, Abián-Franco N. Respuesta de la dermatitis autoinmune por progesterona al acetato de ulipristal. Actas Dermosifiliogr. 2019;110:78–81.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1822 "Ancho" => 1200 "Tamanyo" => 232392 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Erythematous, edematous plaque on the right forearm that is tender and infiltrated to touch measuring some 10<span class="elsevierStyleHsp" style=""></span>cm in diameter. Patch test with progesterone, which was negative at 96<span class="elsevierStyleHsp" style=""></span>hours, and with NorLevo in petrolatum and Progeffik applied directly on the area of the lesion and on healthy skin (B).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1817 "Ancho" => 1200 "Tamanyo" => 494175 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin-eosin, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>40: dense interstitial lymphohistiocytic inflammatory infiltrate (A). Staining with alcian blue<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>100: mucin deposit between collagen bands and throughout the dermis (B).</p>" ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Abbreviations: Ab, antibody; anti-HIS, antihistamines; CS, corticosteroids; CsA, ciclosporin A; FDE, fixed drug eruption; GnRH, gonadotropin-releasing hormone; HCQ, hydroxychloroquine; HRT, hormone replacement therapy; IUD, intrauterine device; OC, oral contraceptive; PG: progesterone.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No. of Cases Published \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dates of Publication \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mean Age (Range), y \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cutaneous Manifestations No. (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Location No. (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Skin Biopsy No. (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Diagnosis No. (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Treatment No. (%) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">97 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1964-2017 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33.01<br>(15-55) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Erythematous, edematous plaques: 32 (32.9)<br><br>Generalized urticaria <span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span> angioedema: 31 (31.9)<br><br>Vesiculobullous rash 13 (13.4)<br><br>Erythema multiforme: 13 (13.4)<br><br>Mucosal erosion: 12 (12.3)<br><br>Eczematous plaques: 10 (10.3)<br><br>Anaphylaxis: 8 (8.24)<br><br>FDE: 3 (3.04)<br><br>Purpura: 2 (2.06)<br><br>Single plaque: 1 (1.03)<br> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Upper limbs: 62 (63.9)<br><br>Trunk: 56 (57.7)<br><br>Lower limbs: 51 (52.57)<br><br>Face and neck: 29 (29.8)<br><br>Oral mucosa: 21 (21.6)<br><br>Genital mucosa: 5 (5.15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No biopsy: 44 (45.36)<br>With biopsy: 53 (54.63)<br><br>Superficial and deep perivascular lymphohistiocytic infiltrate: 42 (79.24)<br><br>Interface dermatitis:<br>– Lichenoid: 2 (3.7)<br>– Vacuolization of the basement layer: 26 (48.38)<br><br>Epidermal changes (hyperkeratosis, acanthosis, spongiosis): 16 (30.18)<br><br>Dermal edema: 7 (13.20)<br>Melanophages: 3 (5.6)<br>Extravasation of blood: 2 (3.77)<br>Subdermal vesicles: 2 (3.77)<br> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Intradermal testing with PG: 73 (75.25)<br><br>Intramuscular PG: 8 (8.24)<br><br>Symptoms: 8 (8.24)<br><br>Intravaginal PG: 3 (3.09)<br><br>Patch tests: 2 (2.06)<br><br>Circulating Ab: 2 (2.06)<br><br>PG oral: 2 (2.06)<br><br>In vitro immunological tests: 1 (1.03)<br> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">OC: 18 (18.55)<br>Conjugated estrogens: 18 (18.55)<br>GnRH analogues: 14 (14.43)<br>Oophorectomy: 11 (11.34)<br>Anti-HIS: 9 (20.61)<br>Tamoxifen: 8 (8.24)<br>Topical C<br>Ss: 8 (8.24)<br>No treatment: 7 (7.2)<br>Systemic CSs: 6 (6.18)<br>Desensitization: 6 (6.18)<br>Danazol: 4 (4.12)<br>Azathioprine: 2 (2.06)<br><br>Pregnancy: 1 (1.03)<br>Dapsone: 1 (1.03)<br>HCQ: 1 (1.03)<br>CsA: 1 (1.03)<br>Removal of IUD: 1 (1.03)<br>Interruption HRT: 1 (1.03)<br> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Case 98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Oscoz-Jaime (2017) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Painful erythematous, edematous plaque measuring 10<span class="elsevierStyleHsp" style=""></span>cm always at the same site \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Right forearm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Interstitial granulomatous infiltrate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Oral PG \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Ulipristal acetate \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1933269.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Summary of Published Cases.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cyclic catamenial dermatoses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T. Hermanns-Lê" 1 => "J.-F. Hermanns" 2 => "M. Lesuisse" 3 => "G.E. Piérard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2013/156459" "Revista" => array:5 [ "tituloSerie" => "BioMed Res Int." "fecha" => "2013" "volumen" => "2013" "paginaInicial" => "156459" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24199187" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Autoimmune progesterone dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "I. Kaygusuz" 1 => "I.I. Gumus" 2 => "E. Sarifakioglu" 3 => "A. Eser" 4 => "B. Bozkurt" 5 => "H. Kafali" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.tjog.2013.12.007" "Revista" => array:6 [ "tituloSerie" => "Taiwan J Obstet Gynecol." "fecha" => "2014" "volumen" => "53" "paginaInicial" => "420" "paginaFinal" => "422" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25286806" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The menstrual cycle and the skin" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.S. Raghunath" 1 => "Z.C. Venables" 2 => "G.W.M. Millington" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Exp Dermatol." "fecha" => "2015" "volumen" => "40" "paginaInicial" => "111" "paginaFinal" => "115" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Autoimmune progesterone dermatitis: Treatment with oophorectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.M. Ródenas" 1 => "M.T. Herranz" 2 => "J. Tercedor" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Br J Dermatol." "fecha" => "1998" "volumen" => "139" "paginaInicial" => "508" "paginaFinal" => "511" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Case of autoimmune progesterone dermatitis presenting as fixed drug eruption" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Asai" 1 => "N. Katoh" 2 => "M. Nakano" 3 => "M. Wada" 4 => "S. Kishimoto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1346-8138.2009.00723.x" "Revista" => array:6 [ "tituloSerie" => "J Dermatol." "fecha" => "2009" "volumen" => "36" "paginaInicial" => "643" "paginaFinal" => "645" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19958448" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Autoimmune progesterone dermatitis that changed its clinical manifestation from anaphylaxis to fixed drug eruption-like erythema" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T. Honda" 1 => "K. Kabashima" 2 => "Y. Fujii" 3 => "M. Katoh" 4 => "Y. Miyachi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/1346-8138.12473" "Revista" => array:6 [ "tituloSerie" => "J Dermatol." "fecha" => "2014" "volumen" => "41" "paginaInicial" => "447" "paginaFinal" => "448" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24750448" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Postovulation dermatitis (dermatitis caused by progesterone)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H. Torras" 1 => "J. Ferrando" 2 => "J. Mallolas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Cutan Ibero Lat Am." "fecha" => "1980" "volumen" => "8" "paginaInicial" => "15" "paginaFinal" => "21" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7022048" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Progestogen Hypersensitivity in 24 Cases: Diagnosis, management, and proposed renaming and classification" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "D. Foer" 1 => "K.M. Buchheit" 2 => "A.R. Gargiulo" 3 => "D.M. Lynch" 4 => "M. Castells" 5 => "P.G. Wickner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaip.2016.03.003" "Revista" => array:6 [ "tituloSerie" => "J Allergy Clin Immunol Pract." "fecha" => "2016" "volumen" => "4" "paginaInicial" => "723" "paginaFinal" => "729" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27090357" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "[Autoimmune progesterone dermatitis]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Z. Lahmam Bennani" 1 => "N. El Fekih" 2 => "D. Baccouche" 3 => "A. Khaled" 4 => "F. Zaglaoui" 5 => "B. Fazaa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.annder.2012.09.008" "Revista" => array:6 [ "tituloSerie" => "Ann Dermatol Venereol." "fecha" => "2012" "volumen" => "139" "paginaInicial" => "832" "paginaFinal" => "835" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23237283" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mechanism of action of ulipristal acetate for emergency contraception: A systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. Rosato" 1 => "M. Farris" 2 => "C. Bastianelli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3389/fphar.2015.00315" "Revista" => array:5 [ "tituloSerie" => "Front Pharmacol." "fecha" => "2015" "volumen" => "6" "paginaInicial" => "315" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26793107" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011000000001/v1_201901030631/S1578219018304153/v1_201901030631/en/main.assets" "Apartado" => array:4 [ "identificador" => "6157" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000011000000001/v1_201901030631/S1578219018304153/v1_201901030631/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018304153?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 15 | 8 | 23 |
| 2024 Octubre | 151 | 58 | 209 |
| 2024 Septiembre | 156 | 43 | 199 |
| 2024 Agosto | 208 | 70 | 278 |
| 2024 Julio | 199 | 43 | 242 |
| 2024 Junio | 153 | 69 | 222 |
| 2024 Mayo | 147 | 44 | 191 |
| 2024 Abril | 122 | 45 | 167 |
| 2024 Marzo | 135 | 42 | 177 |
| 2024 Febrero | 183 | 53 | 236 |
| 2024 Enero | 178 | 36 | 214 |
| 2023 Diciembre | 164 | 30 | 194 |
| 2023 Noviembre | 196 | 29 | 225 |
| 2023 Octubre | 217 | 47 | 264 |
| 2023 Septiembre | 143 | 335 | 478 |
| 2023 Agosto | 149 | 18 | 167 |
| 2023 Julio | 175 | 54 | 229 |
| 2023 Junio | 140 | 42 | 182 |
| 2023 Mayo | 125 | 56 | 181 |
| 2023 Abril | 119 | 35 | 154 |
| 2023 Marzo | 146 | 41 | 187 |
| 2023 Febrero | 145 | 27 | 172 |
| 2023 Enero | 97 | 49 | 146 |
| 2022 Diciembre | 95 | 34 | 129 |
| 2022 Noviembre | 100 | 20 | 120 |
| 2022 Octubre | 83 | 29 | 112 |
| 2022 Septiembre | 101 | 36 | 137 |
| 2022 Agosto | 69 | 29 | 98 |
| 2022 Julio | 58 | 35 | 93 |
| 2022 Junio | 54 | 32 | 86 |
| 2022 Mayo | 153 | 49 | 202 |
| 2022 Abril | 230 | 30 | 260 |
| 2022 Marzo | 199 | 50 | 249 |
| 2022 Febrero | 142 | 28 | 170 |
| 2022 Enero | 156 | 34 | 190 |
| 2021 Diciembre | 125 | 44 | 169 |
| 2021 Noviembre | 111 | 47 | 158 |
| 2021 Octubre | 128 | 83 | 211 |
| 2021 Septiembre | 110 | 47 | 157 |
| 2021 Agosto | 156 | 45 | 201 |
| 2021 Julio | 163 | 34 | 197 |
| 2021 Junio | 132 | 30 | 162 |
| 2021 Mayo | 177 | 39 | 216 |
| 2021 Abril | 219 | 65 | 284 |
| 2021 Marzo | 150 | 35 | 185 |
| 2021 Febrero | 123 | 23 | 146 |
| 2021 Enero | 77 | 17 | 94 |
| 2020 Diciembre | 71 | 18 | 89 |
| 2020 Noviembre | 68 | 14 | 82 |
| 2020 Octubre | 57 | 19 | 76 |
| 2020 Septiembre | 66 | 19 | 85 |
| 2020 Agosto | 52 | 22 | 74 |
| 2020 Julio | 39 | 20 | 59 |
| 2020 Junio | 36 | 26 | 62 |
| 2020 Mayo | 26 | 13 | 39 |
| 2020 Abril | 26 | 18 | 44 |
| 2020 Marzo | 16 | 6 | 22 |
| 2020 Febrero | 4 | 0 | 4 |
| 2020 Enero | 1 | 0 | 1 |
| 2019 Diciembre | 1 | 2 | 3 |
Mostrar todo
