title: Autoimmune progesterone dermatitis and its manifestation as anaphylaxis: a case report and literature review.
abstract: OBJECTIVE
  Autoimmune progesterone dermatitis is a rare cyclic premenstrual reaction to progesterone produced during the luteal phase of a woman's menstrual cycle with a variety of presentations including erythema multiforme, eczema, urticaria, angioedema, and progesterone-induced anaphylaxis. We present a case of progesterone-induced anaphylaxis and a review of literature focusing on its diagnosis and therapy.
  
  
  METHODS
  We surveyed all the literature in English back to 1921 when the first case was published. First, we researched the terms progesterone anaphylaxis, autoimmune progesterone dermatitis, cyclic urticaria, using the PubMed resource. Then we included articles found within these publications' reference sections.
  
  
  METHODS
  We selected articles based on whether the cases described appeared to fit the description of the entity autoimmune progesterone dermatitis. All cases included had dermatologic reactions occurring during the luteal phase of the menstrual period, positive skin or intramuscular reactions to progesterone, and treatment amenable to anovulatory agents and/or hysterectomy with bilateral salpingo-oophorectomy.
  
  
  RESULTS
  We found approximately 50 published cases of autoimmune progesterone dermatitis, and only nine known cases of its manifestation as anaphylaxis. These cases, including the case described by us, are summarized, and successful diagnostic and therapeutic approaches in the literature are reviewed.
  
  
  CONCLUSIONS
  Autoimmune progesterone dermatitis is a rare entity associated with progesterone production of the luteal phase of a woman's menstrual cycle. It can be diagnosed using intradermal or intramuscular progesterone tests and can be treated by disrupting the ovulation cycle using specific medications or by oopherectomy.
authors.affiliation: Allergy and Immunology, James H. Quillen V.A. Medical Center, Johnson City, Tennessee, USA.
authors.forename: Joy L
authors.initials: JL
authors.lastname: Snyder
authors.forename: Guha
authors.initials: G
authors.lastname: Krishnaswamy
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000209:etiology / Q000276:immunology* / Q000628:therapy; D001327:Autoimmune Diseases / Q000209:etiology / Q000276:immunology* / Q000628:therapy; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000276:immunology; D011374:Progesterone / Q000276:immunology*; D014581:Urticaria / Q000209:etiology / Q000276:immunology* / Q000628:therapy
chemical_list: D011374:Progesterone