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Autoimmune progesterone dermatitis. Case report with histologic overlap of erythema multiforme and urticaria.

Walling HW, Scupham RK

Private Practice of Dermatology and Iowa Pathology Associates, Des Moines, Iowa, USA. hobartwalling@yahoo.com

BACKGROUND: Autoimmune progesterone dermatitis is a rare eruption that recurs monthly as progesterone levels peak during the menstrual cycle. Clinical and histologic features are variable, and the eruption is thought to represent a hypersensitivity response to endogenous progesterone. METHODS: We present the case of a 38-year-old woman with a pruritic intermittent facial eruption of 18 months' duration that recurred predictably in the days surrounding menses. RESULTS: The histology showed interface dermatitis with features of both erythema multiforme and urticaria. Intradermal injection of medroxyprogesterone acetate was positive. Her symptoms responded to antihistamine therapy. CONCLUSION: This unusual case is particularly distinctive both in terms of the histologic findings and the response to therapy.

Published 1 April 2008 in Int J Dermatol, 47(4): 380-2.
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