On this weeks episode of The SecretScope we speak about a phototoxic eruption that occurs when the skin is exposed to a photosensitizing compound. The common term for this dermatitis is “Phytophotodermatitis." If you want to listen to our episode now you can do so by CLICKING HERE.
♡ What is Phytophotodermatitis?
A phototoxic eruption caused by exposure to furocoumarin compounds in plants and then to sunlight. Furocoumarins are found in many plants, including citrus fruits (i.e.: limes, lemons, oranges, and grapefruits), celery, parsley, carrots, dill, and figs.
Most cases of phytophotodermatitis develop after exposure to citrus, often when consuming alcoholic beverages, leading to the nicknames such as, “the other lime disease” and “margarita dermatitis.”
When asking your patients about it they will recall making margaritas with fresh limes during a weekend at the beach weekend and also that lime juice was dripping down their forearm in the pattern similar to the pigmented distribution.
♡ Who is at risk & When does it occur?
Children after playing outdoors, outdoor workers such as landscapers, and those employed in the food industry such as bartenders.
It is more common in the spring and summer. Higher heat, humidity and more intense sunlight can enhance the photoreactive response.
Highly variable depending on the caustic agent, distribution, and duration of exposure. Inflammation usually begins within minutes of exposure and peaks at 48 hours. Lesions are typically well-demarcated, erythematous plaques that may progress to vesicles or bullae.
Patients may report associated pain or a burning sensation, usually without itching.
Hyperpigmentation then develops and may last months to years.
Typically it is clinical and based on history findings as well as the appearance of the lesion
Things to look for:
Unusual skin lesions that follow a non-dermatomal distribution
The lack of pruritus helps to distinguish phytophotodermatitis from allergic contact dermatitis.
“Drip lines” may be prominent
Note: Aerosol application of plant-based perfumes may lead to a misted neck rash, and the use of high-powered gardening devices such as a weed eater may lead to widespread lesions.
Typically it's supportive so to alleviate your symptoms you can use:
Wash the site with soap and water
Analgesics, as needed.
Hyperpigmentation can be treated with topical steroids
Knowing how to prevent further causative exposures is important
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