RESUMEN
Autoimmune progesterone dermatitis (APD) is a rare skin condition with a varying morphology, which appears on a monthly basis during the luteal phase of the menstrual cycle and resolves spontaneously with the endogenous decrease in progesterone during menses. We present the case of 39-year-old multiparous Caucasian woman with generalised, self-limited urticaria in her perimenstrual period. APD was diagnosed in light of the cyclical nature of the symptoms. An intradermal test with the administration of 0.5 mg/mL of medroxyprogesterone acetate showed a positive result. She started using vaginal hormonal contraceptive that paradoxically exacerbate the symptoms, which ceased after the removal of the device. An oral combined contraceptive was initiated instead, with complete resolution of the symptoms. We share the case because of the rarity of the situation, emphasising the importance of a multidisciplinary team for differential diagnosis and patient follow up.
Asunto(s)
Enfermedades Autoinmunes/diagnóstico , Anticonceptivos Femeninos/efectos adversos , Dermatitis/diagnóstico , Desogestrel/efectos adversos , Progesterona/efectos adversos , Urticaria/diagnóstico , Administración Intravaginal , Adulto , Androstenos/uso terapéutico , Enfermedades Autoinmunes/tratamiento farmacológico , Anticonceptivos Femeninos/administración & dosificación , Dispositivos Anticonceptivos Femeninos , Anticonceptivos Orales Combinados/uso terapéutico , Dermatitis/tratamiento farmacológico , Desogestrel/administración & dosificación , Etinilestradiol/uso terapéutico , Femenino , Humanos , Fase Luteínica , Urticaria/inducido químicamente , Urticaria/tratamiento farmacológicoAsunto(s)
Anexos Uterinos , Migración de Cuerpo Extraño/diagnóstico , Hernia Abdominal/diagnóstico , Dispositivos Intrauterinos Medicados , Laparoscopía , Epiplón , Ligamento Ancho , Femenino , Herniorrafia/métodos , Humanos , Hallazgos Incidentales , Persona de Mediana Edad , Posicionamiento del PacienteRESUMEN
Gestational age assignment is one of the most important issues in perinatal medicine. Nowadays, the first day of the last menstrual period, when available, is still used as the basis for calculation of gestational age and expected day of confinement. However, most frequently this date is uncertain or even unknown, and thereby gestational age can be confidently estimated by ultrasonographic biometry until 22 weeks of gestation. There is no uniform dating policy when both a valid last menstrual period and ultrasonographic dates are available in determining the date of confinement. When both methods are compared, there are obvious advantages of routine scanning in the first half of pregnancy.
