Autoimmune Progesterone Anaphylaxis

Progesterone induced dermatitis is a rare disorder. it typically occurs in females due to anautoimmune phenomenon to endogenous progesterone production, but can also be caused byexogenous intake of a synthetic progestin. here in, we present a case of autoimmune progesteroneanaphylaxis (aipa) observed in an adolescent female.the patient is an 18-year-old caucasian female with no significant past medical history and noprior exogenous hormone use, who presented to her primary care physician complaining of cyclic skineruptions with dyspnea, cough and respiratory distress. she noted that her symptoms occurredmonthly, just prior to her menses. an intradermal skin test using 0.1 cml of progesterone wasperformed. the patient developed a 15mm wheal after 15 minutes, confirming the diagnosis of aipa.the patient was started on a continuous regimen of an oral conjugated estrogen (0.625mg). the skineruptions and respiratory symptoms have not returned since the initiation of this therapy.autoimmune progesterone dermatitis manifests via the occurrence of cyclic skin eruptions.women with the disorder commonly present with dermatologic lesions in the luteal phase of themenstrual cycle, if there are any other organ involvement in addition to skin (e.g. lung, gi) thereaction should be called as autoimmune progesterone anaphylaxis. diagnosis of aipa is confirmedby performing a skin allergen test using progesterone.