Effect of Omalizumab for Autoimmune Progesterone Dermatitis Refractory to Bilateral Oophorectomy: A Case Report

Abstract Background: Autoimmune progesterone dermatitis (APD) is a rare skin condition caused by sensitivity to high levels of secreted during the luteal phase menstrual cycle. This may be due various pathophysiological mechanisms including Type I and IV hypersensitivity reaction, potential cross-reactivity with other endogenous steroid hormones such as 17-α-hydroxyprogesterone. We present case patient APD who had her flare-up episodes controlled using omalizumab, after bilateral oophorectomy failed resolve symptoms. Clinical Case: A 34-year-old female presented our Endocrine Clinic marked Cushingoid features secondary high-dose oral prednisone prescribed for diagnosed six years earlier. She first developed pruritic maculopapular rash on arms legs just birth second child in 2009. The was also associated headaches diffuse angioedema. It cyclical fashion, beginning one two days before start cycle, ending shortly it complete. severity symptoms increased time went on, flare-ups began include dyspnea, nausea, vomiting abdominal pain. After three persistent symptoms, diagnosis confirmed test. Her were improved use, however breakthrough still occurred. multiple treatment modalities, she elected 2018. However, persisted required prednisone. further complicated vasomotor menopausal progressive iatrogenic Cushing’s syndrome. eventually started Omalizumab, which helped allowed wean off Vasomotor resolved conjugated estrogens bazedoxifene. bony indeterminate pain arthralgias whilst have spite discontinuing Conclusion: To knowledge, this only third successfully treated Omalizumab where literature. Our demonstrates complications menopause oophorectomy, well adverse effects long-term glucocorticoid therapy.