Autoimmune progesterone dermatitis: treatment with oophorectomy

Abstract

Conflict of interest: none declared. Autoimmune progesterone dermatitis (AIPD) is a rare presentation of progesterone hypersensitivity, characterized by recurrent cyclical eruptions during the luteal phase of the menstrual cycle with a variable clinical presentation. A 42‐year‐old woman was evaluated in 2001 with a dermatosis that had begun during her pregnancy the previous year, at 32 weeks of gestation. Lesions were localized to the face, neckline area, trunk and limbs, and consisted of multiple pruritic and erythematous papules and plaques with crusted erosions (Fig. 1a). The dermatitis appeared every month, 5–6 days before the onset of menses and gradually resolved 7–10 days later. The patient had given birth six times and her only medication was oral contraceptive pills (desogestrel 0.15 mg and ethinyl oestradiol 0.02 mg, Mercilon®; Organon, Lisbon, Portugal), which she had taken intermittently for 20 years. Histopathological examination of a biopsy taken from a lesion revealed epidermal hyperplasia and perivascular inflammatory infiltration with mononuclear cells.