Recurrent rash in a young woman

Case history

A 24-year-old woman presented with a four-year history of recurrent episodes of a rash affecting the oral mucosa (tongue) and angles of her mouth (Figure 1). Recently, the rash had also affected the left periorbital, inner thigh and deltoid areas (Figure 2). The attacks occurred monthly, around the time of menstruation, for two years, and then settled for two years, but they had been recurring for three months prior to her presentation.