Contact dermatitis can be exacerbated in the premenstrual phase. Alexander described a patient whose patch test of fragrance mixture led to positive results only in the premenstrual phase but was negative one week after menstrual bleeding (26). This can be explained by the suppression of the cellular immune response by estrogens mentioned previously (9). Considering the increased skin reactivity to contact allergens during the premenstrual phase, in special cases of premenstrual aggravated contact dermatitis, clinicians are advised to consider the phase of the menstrual cycle when interpreting the results of epicutaneous tests (25,26,51). In case of negative skin testing, the repetition of epicutaneous tests during the premenstrual phase might yield positive results.
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