Autoimmune Progesterone Dermatitis: A Case Report and Review of Literature

Autoimmune progesterone dermatitis (APD) is a rare hypersensitivity reaction triggered by progesterone, predominantly affecting women in the luteal phase of the menstrual cycle. This case describes a 50-year-old woman with hypothyroidism and prolonged use of oral contraceptives, who presented with recurrent pruritic skin lesions occurring 3-10 days before menstruation and resolving post-menses. Clinical examination identified the lesions as urticarial plaques. After ruling out other conditions, such as urticarial vasculitis and autoinflammatory syndromes, a diagnosis of APD was established. Despite normal skin biopsy and blood tests, the patient responded well to symptomatic treatment, including antihistamines and topical corticosteroids. Treatment strategies were centered on ovulation suppression with oral contraceptives, while considering anti-progesterone therapies. The patient was reassured and placed on follow-up. While rare, APD should be considered in women with cyclical skin reactions, and diagnosis is primarily clinical, supported by intradermal progesterone testing and response to treatment.