A Case of Estrogen Dermatitis Successfully Treated With Spironolactone

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.