Autoimmune progesterone dermatitis (APD) is a rare skin disorder. Lupus is an autoimmune condition that causes pain and inflammation. Both conditions occur due to abnormal immune system responses, and hormones may play a role in both conditions.

APD causes a rash that occurs when progesterone levels peak during the luteal phase of the menstrual cycle or from increased levels in pregnancy. Symptoms of APD may appear similar to skin symptoms of lupus.

Lupus is an autoimmune disorder that environmental factors and hormone levels may trigger.

This article looks at the link between APD and lupus, their causes, and treatments for each.

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APD is a condition that occurs in response to rising progesterone levels in the luteal phase of the menstrual cycle.

Hormones may also trigger lupus. People with lupus may experience an increase in lupus symptoms — called a lupus flare — before menstruation or menstrual cycle irregularities.

Additionally, lupus may put people at higher risk of developing other autoimmune conditions. People may develop co-occurring autoimmune conditions alongside lupus. This may happen shortly after a lupus diagnosis but can happen at any point.

Lupus and other autoimmune conditions are more common in females than males, which may be due to hormone levels or other differences researchers are investigating.

Sex hormones play an important role in both conditions, as they help to regulate the immune system. Dysregulation of the hormonal system may lead to immune-system disorders.

Oral contraceptives containing progesterone, or exogenous progesterone exposure, may trigger both conditions.

APD is a reaction to progesterone, and it only affects females of childbearing age. Exogenous progesterone may cause the body to form progesterone antibodies, which may then trigger APD.

According to a 2016 article, lupus most commonly affects females of childbearing age. Certain hormones, including progesterone, affect how the immune system functions and the severity of lupus.

Some research suggests that exogenous hormones, which include oral contraceptives and hormone replacement therapy (HRT), may increase the risk of lupus.

Other research has not found a link between the progesterone-only pill and lupus.

Both lupus and ADP cause rashes, but there are differences in how they appear on the skin.

The following slideshow looks at examples of lupus and ADP rashes.

Both APD and lupus occur due to abnormal reactions from the immune system.


APD may be due to internal or external sources of progesterone, which triggers an autoimmune response. This may occur due to changes in progesterone levels during the menstrual cycle or from oral contraceptives.

In many cases, though, people with APD may have no history of exposure to progesterone medications. Corticosteroids with a similar structure to progesterone may cause the same autoimmune reaction.

Some people may also only be able to tolerate low levels of progesterone. During a normal menstrual cycle, progesterone levels rise 10–35 times higher in the luteal phase.

Pregnancy can also increase progesterone levels as much as thousands of times higher. Increased progesterone levels may produce an inflammatory response in some people, causing the rash-like symptoms of APD.


According to the Lupus Foundation of America, lupus may occur due to a combination of genetic and environmental factors.

Hormones, in particular estrogen, may play a role in lupus and the severity of the disease.

Estrogen production is much higher in females, and in 9 of 10 cases, lupus affects females. Researchers are still investigating the exact reasons for this.

Other factors that may play a role in developing or triggering lupus include:

  • genetics, as certain genes may contribute to developing lupus
  • family history of autoimmune diseases
  • ultraviolet (UV) light
  • Epstein-Barr virus or other infections
  • silica dust exposure
  • certain medications, such as sulfa drugs and some antibiotics
  • stress, including emotional and physical
  • exhaustion

According to the Lupus Foundation of America, lupus is diagnosed more often in women who are African American, Asian, Hispanic/Latino, Alaska Native, Native American, Native Hawaiian, or of other Pacific Islander descent.

Treatments may help to manage APD or lupus and help reduce symptoms. In some cases, treatments may resolve APD.


Treatment for APD may involve hormone replacement therapy to suppress ovulation, which prevents progesterone production.

Removal of both the ovaries and fallopian tubes, or a bilateral salpingo-oophorectomy, may resolve symptoms by preventing an autoimmune response.

People may only have this treatment option if other treatments have not been effective, as this will cause early menopause.

People may also be able to treat symptoms with topical treatments, such as antihistamines.


Although there is currently no cure for lupus, treatment can help people manage the condition.

Treatments may include medications to prevent damage to the body and reduce pain, such as:

  • anti-inflammatory drugs and steroids, to reduce inflammation
  • biologics, to regulate the immune system
  • immunosuppressives, to prevent the immune system from attacking the body
  • antimalarials, such as hydroxychloroquine, to help lupus skin issues and decrease joint pain and inflammation
  • anticoagulants, to prevent blood clots

People can work with a healthcare professional to find the best treatment options and create their treatment plan.

This section answers some frequently asked questions about autoimmune progesterone dermatitis and lupus.

Does autoimmune progesterone dermatitis go away?

APD may not resolve without treatment. People may continue to have flares in relation to changing progesterone levels until they reach menopause.

If people become pregnant, symptoms may get better as the body adapts to gradually increasing progesterone levels, or symptoms may worsen.

Although responses may vary, treatment may help reduce symptoms of APD.

How rare is autoimmune progesterone dermatitis?

APD is a rare disorder, with little information available on how many people it may affect.

APD affects females of childbearing age, with an average age of onset around 27 years old. It may also affect menstruating adolescents and older premenopausal females.

APD has a low prevalence but a high rate of misdiagnosis, which may mean healthcare professionals may mistake the condition for another.

APD and lupus occur from an autoimmune response in the body. APD causes a rash at peak progesterone levels, while lupus causes a range of symptoms, including pain and inflammation.

Lupus may increase the risk of other autoimmune conditions, and hormones may be a trigger. APD occurs due to hypersensitivity to increased progesterone levels.

Hormone therapy or removal of the ovaries may treat APD. Medications can also help manage lupus.