Premenstrual syndrome and associated skin diseases related to hypersensitivity to female sex hormones.

OBJECTIVE: To study skin diseases and hypersensitivity to female sex hormones in patients with the premenstrual syndrome (PMS). STUDY DESIGN: Thirty women answered a questionnaire related to PMS and underwent gynecologic, dermatologic and laboratory examinations. Intradermal testing was performed with estradiol valerate, progesterone and placebo. Desensitization treatment was instituted in 15 patients. RESULTS: Ten patients were diagnosed with PMS and concomitant skin disease, including pruritus vulvae, hyperpigmentation, papular eruption and acne vulgaris (group A). Ten patients diagnosed with PMS but without skin disease served as the first control group (group B). The second control group consisted of 10 healthy women (group C). Immediate and delayed hypersensitivity reactions to sex hormones were observed in all patients with PMS and PMS-related skin diseases (groups A and B) but not in healthy women (group C). Desensitization produced a decrease in PMS symptoms and improvement in the skin disease related to PMS. CONCLUSION: Skin diseases may be a part of PMS. Demonstration of a delayed allergic reaction to female sex hormones may uncover a significant pathogenetic mechanism in patients with recurrent skin disease and PMS.