![]() In 1921, the first case of APD was published in which premenstrual serum causing urticarial lesions was observed . ![]() Although pathogenesis of this clinical condition is not yet clear, the major mechanism is considered to be exposure to exogenous and/or endogenous progesterone causing hypersensitivity reactions leading to clinical manifestation of this disease . She was advised to resume her OCPs and followed up with obstetricians-gynecologists (OB-GYN) and dermatologist as an outpatient for long-term control of her symptoms.Īutoimmune progesterone dermatitis is a rare type of hypersensitivity disease recurring monthly in women during menstrual cycle. Our patient was diagnosed with autoimmune progesterone dermatitis based on history and physical examination. The patient was then discharged home with a six-week taper of steroids with topical clobetasol. Blisters on her extremities began to resolve as no inflamed bullae were noted, and the patient no longer required morphine for pain management. On the sixth day of hospitalization, the patient was able to tolerate a solid diet with minimal dysphagia. During the course of hospitalization, her blisters in the oral mucosa began to regress, allowing for her to drink liquids with minimal pain. Airway was noted to be stable with no dyspnea or stridor. Her blisters began to easily tear, and some formed central umbilication. She was unable to open her mouth or eat as blisters in her oral mucosa continued to worsen. In the following few days, she continued to feel severe pain which was only partially alleviated by morphine and continued to have new lesions in oral cavity and lower extremities. On the second day of her hospital day, she was started on topical clobetasol as well. After receiving a loading dose of 125mg IV Solu-Medrol, she was started on both IV Solu-Medrol 60mg and diphenhydramine 25mg twice a day. The patient was primarily treated with intravenous steroids and diphenhydramine. ![]() Hepatitis C virus (HCV), HIV, and syphilis were ruled out as well. Blood culture and urine analysis were normal. The patient's white cell count was marginally elevated during the course of hospital stay, whereas the eosinophil count remained within normal limits. Other vital signs were also within normal limits. The patient had an initial temperature of 103.3 ☏ in emergency room.
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