Dienogest-associated capillaroscopic abnormalities: a case report and narrative review of progestin microvascular effects

Angelo Nigro
In: Hormone Molecular Biology and Clinical Investigation · 2026 · doi:10.1515/hmbci-2025-0029 · PMID:42184381 · W7162246845
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case report and review detail dienogest-associated capillaroscopic abnormalities, highlighting progestins' complex, dose-dependent microvascular effects, including modulation of endothelial function and vascular tone.

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Abstract

Progestins are widely used for endometriosis with proven efficacy and favorable safety. Their microvascular effects, however, are not fully understood. We report a 35-year-old woman who developed recurrent hand erythema and significant nailfold videocapillaroscopy abnormalities after starting dienogest. This prompted a review of available evidence on the vascular impact of progestins, particularly dienogest. Current data indicate complex, dose-dependent effects on microcirculation. Dienogest appears to have a more favorable profile than other synthetic progestins, with limited impact on endothelial adhesion molecules and preservation of estrogen-induced vasodilation. Nonetheless, progestins can modulate endothelial proliferation, angiogenic factor expression, and vascular tone through genomic and non-genomic mechanisms. While generally safe, individual susceptibility to vascular effects may occur. Clinicians should be aware of potential microvascular manifestations during progestin therapy and consider capillaroscopy in patients presenting with relevant cutaneous changes.

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Condition tags

endometriosis

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (25)

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europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
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License: CC0 · commercial use OK