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The family physician (FP) diagnosed phytophotodermatitis caused by lime juice and sun exposure on the beach. Note the handprint of her fiance who had been squeezing limes into their tropical drinks. This contact occurred when they posed for a photograph. Postinflammatory hyperpigmentation is present along with the erythema
Phytophotodermatitis is a phototoxic reaction to psoralens, which are plant compounds found in limes, celery, figs, and certain drugs. They can cause dramatic inflammation and bullae where the psoralen comes into contact with the skin. Accompanying hyperpigmentation is a good clue to a phytophotodermatitis reaction.
It helps to ask the patient if she, or he, has had any contact with limes, celery, or figs. Squeezing lime juice into drinks is a particularly common cause of this reaction.
Acute episodes of photodermatitis respond rapidly to topical and/or oral corticosteroids. Topical steroids should provide symptomatic relief and decrease the inflammation. For more severe reactions, a course of prednisone daily for 5 to 7 days may be used.
In this case, the FP prescribed triamcinolone 0.1% cream to be applied to the affected areas twice a day. The patient was advised to use sunscreen to prevent further hyperpigmentation. Although most lesions fade with time, a topical bleaching agent such as hydroquinone may be prescribed to reduce hyperpigmentation
Text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. Photo courtesy of Andrea Darby-Stewart, MD. This case was adapted from: Mayeaux EJ, Wenner C. Photodermatitis. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009:853-857.
To learn more about The Color Atlas of Family Medicine, see:
• http://www.amazon.com/Color-Atlas-Family-Medicine/dp/0071474641
You can now get The Color Atlas of Family Medicine as an app for mobile devices including the iPhone and iPad by clicking this link:
The family physician (FP) diagnosed phytophotodermatitis caused by lime juice and sun exposure on the beach. Note the handprint of her fiance who had been squeezing limes into their tropical drinks. This contact occurred when they posed for a photograph. Postinflammatory hyperpigmentation is present along with the erythema
Phytophotodermatitis is a phototoxic reaction to psoralens, which are plant compounds found in limes, celery, figs, and certain drugs. They can cause dramatic inflammation and bullae where the psoralen comes into contact with the skin. Accompanying hyperpigmentation is a good clue to a phytophotodermatitis reaction.
It helps to ask the patient if she, or he, has had any contact with limes, celery, or figs. Squeezing lime juice into drinks is a particularly common cause of this reaction.
Acute episodes of photodermatitis respond rapidly to topical and/or oral corticosteroids. Topical steroids should provide symptomatic relief and decrease the inflammation. For more severe reactions, a course of prednisone daily for 5 to 7 days may be used.
In this case, the FP prescribed triamcinolone 0.1% cream to be applied to the affected areas twice a day. The patient was advised to use sunscreen to prevent further hyperpigmentation. Although most lesions fade with time, a topical bleaching agent such as hydroquinone may be prescribed to reduce hyperpigmentation
Text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. Photo courtesy of Andrea Darby-Stewart, MD. This case was adapted from: Mayeaux EJ, Wenner C. Photodermatitis. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009:853-857.
To learn more about The Color Atlas of Family Medicine, see:
• http://www.amazon.com/Color-Atlas-Family-Medicine/dp/0071474641
You can now get The Color Atlas of Family Medicine as an app for mobile devices including the iPhone and iPad by clicking this link:
The family physician (FP) diagnosed phytophotodermatitis caused by lime juice and sun exposure on the beach. Note the handprint of her fiance who had been squeezing limes into their tropical drinks. This contact occurred when they posed for a photograph. Postinflammatory hyperpigmentation is present along with the erythema
Phytophotodermatitis is a phototoxic reaction to psoralens, which are plant compounds found in limes, celery, figs, and certain drugs. They can cause dramatic inflammation and bullae where the psoralen comes into contact with the skin. Accompanying hyperpigmentation is a good clue to a phytophotodermatitis reaction.
It helps to ask the patient if she, or he, has had any contact with limes, celery, or figs. Squeezing lime juice into drinks is a particularly common cause of this reaction.
Acute episodes of photodermatitis respond rapidly to topical and/or oral corticosteroids. Topical steroids should provide symptomatic relief and decrease the inflammation. For more severe reactions, a course of prednisone daily for 5 to 7 days may be used.
In this case, the FP prescribed triamcinolone 0.1% cream to be applied to the affected areas twice a day. The patient was advised to use sunscreen to prevent further hyperpigmentation. Although most lesions fade with time, a topical bleaching agent such as hydroquinone may be prescribed to reduce hyperpigmentation
Text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. Photo courtesy of Andrea Darby-Stewart, MD. This case was adapted from: Mayeaux EJ, Wenner C. Photodermatitis. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009:853-857.
To learn more about The Color Atlas of Family Medicine, see:
• http://www.amazon.com/Color-Atlas-Family-Medicine/dp/0071474641
You can now get The Color Atlas of Family Medicine as an app for mobile devices including the iPhone and iPad by clicking this link: