Moreover, we remember that some reports have indicated the Sweet’s syndrome-like eruptions as cutaneous side-effect of combined oral contraceptives.

This   disease   is   a   rare   immunologically   mediated   condition characterized by an atypical neutrophilic reaction to the hormonal contraceptives; consequently,  on cessation of their use,  there is complete resolution of the lesions. General malaise and fever,  sometimes associated with palatal ulceration and/or migratory thrombophlebitis accompanie these eruptions (papules, nodules and plaques) of 2-3 week duration_(15,16). When facial eruption was associated, the first worned diagnosis may be rosacea fulminans but the skin biopsy may help to clarify the nature of these cutaneous lesions_(17,18,19). 

Furthermore,  cases of erythema nodosum appeared with   combined hormonal contraceptive intake,disappeared with discontinuation and relapsed with resumption of the retake had been reported. Oral contraceptives, as well as many other drugs, have been associated with erythema nodosum_(20,21,22).  In the oral cavity. candida colonization could be detected more frequently than in vagina and the influence of hormonal contraceptives could be pointed out _(23,24).

Regarding this condition, apart from direct skin attack,  is much discussed the occurrence of immuno-allergic reactions of the skin,  considering their usual saprophytic characteristics ₍₂₅₎.  The role of hormonal contraceptives in malignant melanoma remains controversial ₍₂₆₎.

Autoimmune Progesterone dermatitis is an uncommon disorder. It typically occurs in females due to an autoimmune phenomenon to endogenous progesterone production, but can also be caused by exogenous intake of a synthetic progestin.

There was no relationships to estrogen levels.  Generally,  these women refer a monthly cyclic skin eruption with pruritus, just prior to her menses.  Erythema multiforme appears 48 hours after intramuscular 10mg progesterone or 10 mg medroxyprogesterone₍₂₇₎.

However,  this   entity   can   induce   a   variety   of manifestations including erythema multiforme, eczema, urticaria, angioedema and progesterone- induced anaphylaxis₍₂₈₎. A case of progesterone-induced cyclical erythema multiforme had been reported.  The patient,  33 years of age,  suffered from recurrent pruritic annular and target lesions on the hands, feet, and trunk and oral laceration from 1977-83. She had taken oral contraceptives in 1972 without adverse effects.  The eruptions began in the 2nd half of the menstrual cycle, worsened through the luteal phase, and were at their most florid on days 2-4 of menstrution. 

There   was   no   relationship   to   estrogen   levels;  however,  the postovulatory progesterone peak, as indicated by serial serum progesterone levels, corresponded to the initiation of eruptions.  Erythema multiforme was induced within 48 hours by intramuscular injection of 10 mg progesterone or 10 mg medroxyprogesterone; this further evoked a rise in circulating immune complexes for 48 hours₍₂₈₎.  There was no indication that the erythema multiforme was associated with menstrual-linked herpes simplex or the use of analgesics during menstruation. Autoimmune progesterone dermatitis is often associated with prior exposure to synthetic progesterones, as in this case₍₂₉₎. It has been suggested that the synthetic progesterone acts as a stimulus for antibodies which cross-react with natural progesterone.  The antiestrogen tamoxifern was used successfully in this case and is a valuable alternative to treatment with oophorectomy.