Autoimmune progesterone dermatitis manifesting as generalized fixed drug eruption

Area of Science:

• Dermatology
• Immunology
• Endocrinology

Background:

• Autoimmune progesterone dermatitis is an uncommon dermatosis linked to hypersensitivity reactions to progestagens.
• It often presents as urticaria, eczema, or erythema multiforme-like lesions.
• The condition is poorly recognized and frequently under-diagnosed.

Observation:

• A 26-year-old woman presented with violaceous plaques on the groin and abdomen.
• Lesions appeared 4 days after a spontaneous abortion and uterine curettage.
• Recurrent monthly eruptions at the same sites mimicked a fixed drug eruption.

Findings:

• Histopathology was consistent with a fixed drug eruption.
• Positive intradermal testing to progesterone was noted.
• Symptomatic improvement occurred after treatment with oral contraceptive pills.

Implications:

• This case highlights the diagnostic challenges of autoimmune progesterone dermatitis.
• Intradermal testing and response to oral contraceptives can aid in diagnosis.
• Increased awareness is crucial for timely diagnosis and management of this catamenial dermatosis.