A teen after a day at the beach.

PHYTOPHOTODERMATITIS

Phytophotdermaititis is a type of phototoxicity (in contrast to a photoallergy).

• Phototoxicity clinically resembles an exaggerated sunburn. The incidence is comparatively higher, it may occur on the first exposure, the dose of the chemical and ultraviolet radiation are important and the diagnosis is clinical.
• Common causes of phytophotodermatitis include contact with lime, lemon, celery, parsnip, and figs.
  
• Some patients develop this after using lime or lemon juice applied to their hair while out in the sun in an attempt to bleach their hair.
• The most common cause in San Diego (personal observation) is contact with limes on a sunny day. Patients may be at the beach or park and use limes for either drinks or in salads. One child picked limes from a lime tree while playing outside.
  
• I like to call it "Lime Disease"!
• Fig leaf application to the feet has been used as a home remedy for onychomycosis, psoriasis, eczema and other complaints of the feet. The patients then go out in the sun and develop a severe sunburn/blistering.

Clinical

The area is like a burn. Redness, pain and inflammation develop hours to 1-2 days after exposure. Within a few days, the area takes on a red/brown color.

Treatment

Further sun exposure should of course be avoided. A topical steroid and/or a soothing cream may ease symptoms until the condition resolves. Postinflammatory hyperpigmentation is common. The color may take months to return to normal A topical bleaching cream may be given after the inflammation resolves.

Additional Photographs

Streaky, haphazard brown patches are typical.

The dorsal hand and in severe cases, blistering are typical.

Squeezing limes and then going out in the sun.

RegionalDerm

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