A 25-year-old Indian woman developed a distinctive papulopustular eruption, transient arthritis, peripheral and tissue hypereosinophilia, followed by spontaneous abortion on two successive pregnancies. The striking histopathologic feature in the disease is the intense accumulation of eosinophils in hair follicles, within the epidermis, and within the dermis and subcutaneous tissue. Intradermal skin testing with aqueous progesterone produced a delayed hypersensitivity reaction, with identical histopathologic features present in the naturally occurring disease. Administration of an oral contraceptive mixture containing norethindrone and mestranol (Norinyl 1 + 50) resulted in a severe exacerbation of the clinical and laboratory features of the naturally appearing disease; these symptoms could be reversed dramatically by oral administration of conjugated aqueous estrogen. Autosensitive progesterone dermatitis of pregnancy appears to be a new clinical and histopathologic entity.
Bierman SM. Autoimmune Progesterone Dermatitis of Pregnancy. Arch Dermatol. 1973;107(6):896–901. doi:10.1001/archderm.1973.01620210060016