A Case of Estrogen Dermatitis Successfully Treated With Spironolactone

TL;DR

A rare skin condition called estrogen dermatitis was successfully treated with spironolactone in a patient with PCOS and acne.

Contribution

This case demonstrates spironolactone as a viable treatment for estrogen-sensitive skin conditions when estrogen-based therapies are not possible.

Findings

The patient's rash resolved completely with spironolactone treatment.

Estrogen dermatitis symptoms improved during the menstrual cycle, indicating hormone sensitivity.

Spironolactone may be a promising alternative for patients who cannot use estrogen-based therapies.

Abstract

Estrogen dermatitis is a rare dermatologic condition characterized by a rash that worsens during periods of rising estrogen and improves when estrogen levels fall during menstruation. Because of variability in morphology and histopathology, it may mimic and/or overlap with other inflammatory skin disorders. Here, we describe a case of suspected estrogen dermatitis associated with polycystic ovarian syndrome (PCOS), hidradenitis suppurativa, and acne. The patient noted symptom improvement during her menstrual cycle. Clinical presentation and histopathological findings were non-specific. Because of a history of migraines with aura, the patient was not a candidate for combined oral contraceptives. She was started on spironolactone, which led to complete resolution of the rash. This case highlights the potential of anti-androgen therapy, such as spironolactone, as a promising treatment option for estrogen-sensitive skin conditions, particularly in patients who have contraindications for estrogen-based therapies.

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