Estrogen dermatitis: a dendritic-cell-mediated allergic condition.

BACKGROUND: Most estrogen dermatitides are induced by local or systemic contact dermatitis where dendritic cells are central, and tamoxifen has a blocking effect on dendritic cells. METHODS: We present 5 cases of estrogen dermatitis in which the clinical features were prurigo, urticaria, acneiform eruption and annular erythema. RESULTS: Tamoxifen was effective in 3 of 4 cases. Three of 4 biopsy specimens showed the formation of Langerhans cell nests in the epidermis and hair follicles and perivascular infiltration of CD4+ and CD8+ lymphocytes in the dermis. CONCLUSION: These results suggest that a dendritic-cell-mediated allergic mechanism is involved in estrogen dermatitis.