Linear Hyperpigmentation in Chronic Phytophotodermatitis from Limes

Dreher, Katie; Evans, Megan S.

doi:10.1016/j.jpeds.2021.07.045

Cited by 5 publications

(5 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For symptomatic management in the acute phase, given that it is non-immunological and inflammatory, this can best be treated as if it was a sunburn, which involves cool compresses, emollients, and/or oral analgesics [ 1 , 2 ]. If pruritic or inflamed, physicians may prescribe topical, low-potency corticosteroids [ 6 ]. If widespread, you can attempt a 2-3-week course of corticosteroids [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…Advise not to attempt topical anesthetics due to the potential of contact allergy. On the other hand, in the chronic phase, topical steroids are not typically indicated, being that the inflammatory process has already resolved [ 6 ]. As for cosmetic management, you can trial bleaching products, such as hydroquinone [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…The acute phase can be completely asymptomatic, or it can involve inflammatory patterns ranging from an erythematous or edematous rash to vesicles or bullae that are sometimes pruritic just hours to days after exposure [ 6 , 8 ]. These skin lesions can also present as either linear or bizarre, irregularly shaped patterns [ 5 , 6 ]. If the acute phase does not resolve spontaneously, then a chronic phase can occur due to a delayed post-inflammatory reaction by psoralen-stimulated melanin hyperproduction, leading to hyperpigmented skin lesions that can last weeks for months [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Once exposed, a photosensitivity reaction occurs, causing damage to cell DNA and membranes and subsequent cell destruction and injury to the epidermis [1]. This reaction causes a broad spectrum of cutaneous manifestations that begin as an acute phase and sometimes progress into a chronic phase [6,7]. The acute phase can be completely asymptomatic, or it can involve inflammatory patterns ranging from an erythematous or edematous rash to vesicles or bullae that are sometimes pruritic just hours to days after exposure [6,8].…”

Section: Introductionmentioning

confidence: 99%

“…This reaction causes a broad spectrum of cutaneous manifestations that begin as an acute phase and sometimes progress into a chronic phase [6,7]. The acute phase can be completely asymptomatic, or it can involve inflammatory patterns ranging from an erythematous or edematous rash to vesicles or bullae that are sometimes pruritic just hours to days after exposure [6,8]. These skin lesions can also present as either linear or bizarre, irregularly shaped patterns [5,6].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Phytophotodermatitis From Lime Margaritas on a Mexico Vacation

Cochran,

Jallo,

Coican

et al. 2024

Cureus

View full text Add to dashboard Cite

Phytophotodermatitis is a type of contact dermatitis that occurs upon skin exposure to certain plant chemicals, known as furocoumarins, along with simultaneous sun exposure. This case details a 34-year-old patient who presented to the office with an asymptomatic, irregularly shaped, and hyperpigmented patch located on the left inferior middle back that had been present since a recent beach vacation in Mexico. Upon gathering the history, clinicians should inquire about recent sunlight exposure while consuming and/or touching phytotoxic plant derivatives found in most citrus plants. The history should correspond with the skin examination findings and conclude that a cutaneous phytotoxic reaction had occurred when a lime margarita contacted the hand, which was subsequently rubbed onto the patient’s back. This case highlights the importance of both taking a thorough history and physical examination and being aware of the broad range of skin manifestations to prevent unnecessary treatment, such as topical corticosteroids, for other skin disorders (the irregular presentation of atopic dermatitis, allergic contact dermatitis, and dermatitis unspecified) or improperly suspected child abuse in younger patient presentations.

show abstract