title: Autoimmune progesterone dermatitis: Case report of an unexpected treatment reaction.
abstract: Autoimmune progesterone dermatitis (APD) is a rare skin condition with a varying morphology, which appears on a monthly basis during the luteal phase of the menstrual cycle and resolves spontaneously with the endogenous decrease in progesterone during menses. We present the case of 39-year-old multiparous Caucasian woman with generalised, self-limited urticaria in her perimenstrual period. APD was diagnosed in light of the cyclical nature of the symptoms. An intradermal test with the administration of 0.5 mg/mL of medroxyprogesterone acetate showed a positive result. She started using vaginal hormonal contraceptive that paradoxically exacerbate the symptoms, which ceased after the removal of the device. An oral combined contraceptive was initiated instead, with complete resolution of the symptoms. We share the case because of the rarity of the situation, emphasising the importance of a multidisciplinary team for differential diagnosis and patient follow up.
authors.affiliation: Department of Medicine, Internal Medicine Service, Hospital Pedro Hispano, Matosinhos, Portugal.
authors.forename: Sara
authors.initials: S
authors.lastname: Camões
authors.affiliation: Department of Gynaecology and Obstetrics, Hospital Pedro Hispano, Matosinhos, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Sampaio
authors.affiliation: Department of Medicine, Dermatology Service, Hospital Pedro Hispano, Matosinhos, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Rocha
authors.affiliation: Department of Gynaecology and Obstetrics, Hospital Pedro Hispano, Matosinhos, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Tiago
authors.affiliation: Basic & Clinical Immunology Unit, Faculty of Medicine, University of Porto, Porto, Portugal.|Department of Medicine, Allergy Unit, Hospital Pedro Hispano, Matosinhos, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Lopes
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D000736:Androstenes / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000188:drug therapy; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects*; D003274:Contraceptive Devices, Female; D003277:Contraceptives, Oral, Combined / Q000627:therapeutic use; D003872:Dermatitis / Q000175:diagnosis* / Q000188:drug therapy; D017135:Desogestrel / Q000008:administration & dosage / Q000009:adverse effects*; D004997:Ethinyl Estradiol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008183:Luteal Phase; D011374:Progesterone / Q000009:adverse effects*; D014581:Urticaria / Q000139:chemically induced / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000736:Androstenes; D003271:Contraceptive Agents, Female; D003277:Contraceptives, Oral, Combined; C044815:etonogestrel; D004997:Ethinyl Estradiol; D011374:Progesterone; D017135:Desogestrel; C035144:drospirenone
keywords: allergy and immunology; autoimmune dermatology; progesterone dermatitis; urticaria