Atopic dermatitis exacerbations seen in premenstrual period

(HealthDay)—Child-bearing-aged women with moderate-to-severe atopic dermatitis (AD) have disease exacerbations in the premenstrual period, according to a research letter published online Dec. 15 in the Journal of the American Academy of Dermatology.

Giacomo Dal Bello, M.D., from the University of Verona in Italy, and colleagues examined symptoms and disease severity variations during the menstrual cycle among child-bearing-aged women with AD. Women aged 18 to 45 years with AD (87 women) or psoriasis (82 women) were asked to complete a questionnaire about their skin disease and gynecologic features; they were evaluated for three consecutive months during the premenstrual, menstrual, and postmenstrual periods.

The researchers found that women with moderate-to-severe AD manifested significant exacerbations in disease severity and itch and deterioration in quality of life in the premenstrual versus menstrual period and much worse manifestations compared with the postmenstrual period. The mean worsening was 17.7, 35.3, and 26.3 percent in the eczema area and severity index score, numerical rating scale worst itch, and dermatology life quality index, respectively. The exacerbation of AD in the premenstrual period was associated with higher age at menarche and a longer menstrual period. No association was seen between premenstrual exacerbation of AD and presence of premenstrual syndrome or premenstrual dysphoric disorder. Variations of disease symptoms were not seen in relation to menstrual phase for patients with mild AD and those with psoriasis.

"A high number of fertile women with AD present disease exacerbation in the premenstrual period," the authors write. "These aspects deserve attention for more comprehensive patient management."

Several authors disclosed financial ties to the pharmaceutical industry.

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