A young woman with autoimmune progesterone dermatitis

Case scenario

Jude is 22 years old and for several years has been having monthly flares of an irritating dermatitis that erupts on her trunk and proximal limbs. She says that each outbreak starts at about the time she is in the middle of her menstrual cycle, and only subsides when her next period arrives. Her skin becomes red and itchy, papules develop, which she frequently scratches and infects, and she is left with residual scars. Jude says that no standard treatment for dermatitis has helped her – not even a course of oral corticosteroids.

Could she be allergic to her own progesterone? How should she be managed?