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When to Suspect APD APD should be suspected when: Skin symptoms recur monthly despite standard dermatologic treatment Symptoms reliably worsen before menstruation Reactions appear after starting progesterone or progestins Antihistamines provide partial but not complete relief Related: Histamine Intolerance: What It Is & What to Do About It APD Causes and Risk Factors APD develops due to an autoimmune response to progesterone, though the exact mechanism of this hypersensitivity is not fully understood

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