A premenstrual urticarial eruption treated with bilateral oophorectomy and hysterectomy

Summary Recurrent episodes of urticaria and erythema multiforme which occur in the luteal phase of each menstrual cycle are well recognized, albeit rare. This clinical entity was described by Hart (1977)1 and attributed to a hypersensitivity to endogenous progesterone. We report a patient with a cyclical urticarial eruption which commenced during pregnancy and recurred pre-menstrually over a period of 11 years. Her symptoms were controlled by suppressing ovulation and finally by bilateral oophorectomy and hysterectomy. Post-operative challenge with an oral oestrogen resulted in a prompt recurrence of the eruption, whereas the administration of a progesterone had no effect. We suggest that this premenstrual eruption was oestrogen-rattier than progesterone-dependent.