Autoimmune progesterone dermatitis with persistent amenorrhoea

A case of autoimmune progesterone dermatitis is reported. The patient developed a recurrent eruption, primarily on the extremities, after receiving oral progesterone for the treatment of persistent amenorrhoea. Intradermal injection of 17 alpha-hydroxyprogesterone produced a positive skin reaction after 30 min, but no delayed onset reaction was observed. A patch test with progesterone in petrolatum was negative. The lymphocyte transformation test was normal. Histamine release from passively sensitized peripheral blood leukocytes was increased by progesterone preincubated in normal serum as a stimulating antigen. Conjugated oestrogen therapy suppressed the rash. Cyclical eruptions with elevated basal body temperature persisted for more than 20 months without menstruation.