LAUSR

the copper IUD. An additional 5 months later, at her second follow-up visit, she mentioned that the copper IUD was removed due to excessive bleeding and subsequently had recurrences of a similar rash within 1 week of menstruation. Given the minimal symptom improvement with betamethasone dipropionate 0.05% cream, the patient was switched to clobetasol 0.05% cream BID, which greatly improved her pruritus symptoms. She has remained controlled on this medication ever since. Autoimmune progesterone dermatitis (APD) is a rare reaction to progesterone that predominately affects women of childbearing age. It has varied presentations, including urticaria, anaphylaxis, erythema multiforme, and vesiculobullous eruptions. While it is classically diagnosed by a wheal and flare reaction following intradermal progesterone patch testing, it is difficult to obtain the aqueous solution of progesterone necessary to perform this test in the United States. We navigated this by performing a modified patch test using an oil-based, non-aqueous progesterone and noted erythematous wheal formation thereafter, confirming the diagnosis of APD. Although our patient experienced the classical symptoms of APD, her symptoms were likely exacerbated by the LIUD, which was confirmed by the improvement of symptoms following its removal. Interestingly, she still experienced pruritus refractory to antihistamines, but her symptoms improved with the usage of topical clobetasol. Further research is needed on alternative diagnostic measures for APD given the difficulty in obtaining proper diagnostic measures and on treatments to improve cutaneous symptoms other than menstrual cycle suppression.