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Autoimmune progesterone dermatitis. Case report with histologic overlap of erythema multiforme and urticaria
Hobart W Walling1, Richard K Scupham
1Private 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.
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