Autoimmune progesterone dermatitis presenting as fixed drug eruption

Area of Science:

• Dermatology
• Endocrinology
• Immunology

Background:

• Autoimmune progesterone dermatitis (APD) is a rare condition causing cyclical skin eruptions related to elevated progesterone levels during the premenstrual phase.
• APD lacks specific cutaneous manifestations, often presenting as common dermatological conditions, posing diagnostic challenges.

Observation:

• A young woman experienced recurrent, cyclical erythema, pain, and itching on a hyperpigmented thigh patch, preceding her menstrual cycle.
• The symptoms resolved shortly after menstruation, consistent with a progesterone-mediated reaction.

Findings:

• Intradermal progesterone sensitivity testing yielded a positive result.
• Histopathology of the affected skin revealed features consistent with a fixed drug eruption.
• The diagnosis of APD presenting as a fixed drug eruption was established.

Implications:

• This case highlights the diagnostic complexity of APD due to its varied presentations.
• Timely diagnosis and appropriate treatment, such as oral contraceptive pills, are crucial for managing APD and improving patient outcomes.
• Reporting rare cases like this enhances clinical awareness and understanding of APD's presentation and management.