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Table 2 Treatment options used in autoimmune progesterone dermatitis

From: Autoimmune progesterone dermatitis in a patient with endometriosis: case report and review of the literature

Treatment Option Advantages Disadvantages
Oral Contraceptives (OCPs) - Usually tried as initial therapy - Limited success due to the progesterone component of OCPs
  - Fewer side effects than other most other therapies  
Antihistamines - Well tolerated, few side effects - Rarely effective as monotherapy
   - Does not address underlying mechanism
Conjugated Estrogens - Avoids progesterone component of OCPs - Increased risk of endometrial cancer, not commonly used today
   - Often require high doses
Glucocorticoids - Able to suppress multiple components of the immune system - Usually not effective alone
  - Can be combined with other therapies - Often require high doses
GnRH Agonists - Often used if OCPs and glucocorticoids are not effective - Can cause symptoms of estrogen deficiency (hot flashes, decreased bone mineral density)
Alkaylated Steroids - Can be combined with low dose steroids - Can cause symptoms of excess androgens (facial hair, hepatic dysfunction, mood disorders)
  - Interferes with gonadal hormone receptors  
Tamoxifen - Has been used successfully in patients unresponsive to conjugated estrogen - Can cause symptoms of estrogen deficiency
   - Increased risk of venous thrombosis and cataract formation
Bilateral oopherectomy - Definitive treatment, used if medical options unsuccessful - Surgical procedure, associated morbidity
   - Symptoms of estrogen deficiency