|Phytophotodermatitis caused by lime|
Phytophotodermatitis, also known as Berloque dermatitis or Margarita photodermatitis, is a skin condition caused by a chemical reaction that leaves skin hypersensitive to ultraviolet light. It is frequently mistaken for hereditary conditions such as atopic dermatitis or chemical burns. In fact, phytophotodermatitis results from contact with certain photosensitizing compounds—such as furanocoumarins—found naturally in some plants and vegetables such as parsnips. These same compounds are also found in citrus fruits, especially limes, hence the alternative name "lime disease" (not to be confused with Lyme disease). Symptoms include burning, itching and large blisters that slowly accumulate over time.
Before the mid-twentieth century, reports of plant-based dermatitis failed to recognize the crucial role of ultraviolet radiation. In 1942, Klaber introduced the term "phytophotodermatitis" to emphasize that both plants and light were required to affect a reaction. An early description of the disease was made by Darrell Wilkinson, a British dermatologist in the 1950s.
The symptoms are equivalent to photodermatitis, but vary in severity. The skin condition is a cutaneous phototoxic inflammatory eruption resulting from contact with light-sensitizing botanical substances—particularly from the plant families Umbelliferae, Rutaceae, Moraceae, and Leguminosae—and ultraviolet light, typically from sun exposure. Phytophotodermatitis usually results in hyperpigmentation of the skin that often appears like a bruise. This may be accompanied by blisters or burning. The reaction typically begins within 24 hours of exposure and peaks at 48–72 hours after the exposure.
Phytophotodermatitis can affect people of any age. Because of the bruise-like appearance that is usually in the shape of handprints or fingerprints, it can be mistaken in children for child abuse.
- Parsnip, parsley, celery, common hogweed, giant hogweed
- Carrot and wild carrot
- Notobubon galbanum (previously known by the synonym Peucedanum galbanum), a South African plant also known as "blister bush", "hog's fennel", or locally in Afrikaans as bergseldery (i.e. "mountain celery")
- Lemon, lime, bergamot orange
- Common rue (Ruta graveolens) and other plants in the genus Ruta
- Sclerotinia sclerotiorum, which can infect celery
- Common fig, its latex contains various furocoumarin isomers such as 8-methoxypsoralen, which induce allergic photodermatitis
- Dictamnus (commonly known as the "burning bush")
- Ambrette Abelmoschus moschatus 
The first and best line of defense against phytophotodermatitis is to avoid contact with phototoxic substances in the first place:
- Avoid contact with the Apiaceae family of plants and other biological agents known to have phototoxic effects. Do not incinerate phototoxic plants and agents since this will serve to disperse the phototoxic substances more widely.
- In situations where contact with phototoxic plants is likely, wear long pants and a long-sleeve shirt. Wear gloves and protective eyewear before handling such plants.
- If protective clothing is not available, apply sunscreen to exposed areas. This will provide some measure of protection if contact is made.
- After an outdoor activity, take a shower or a bath as soon as possible. Wash your clothing and then wash your hands after handling the dirty clothes.
A second line of defense is to avoid sunlight, so as not to activate a phototoxic substance:
- If you come in contact with a phototoxic substance, immediately wash the affected area with soap and water, and avoid any further exposure to sunlight for at least 48 hours.
- Stay indoors, if possible. Be careful to avoid light shining through windows.
- If staying indoors is not an option, cover the affected area with sun protective clothing.
Phytophotodermatitis is triggered by long wavelength ultraviolet light (called UVA) in the range of 320–380 nanometers, so the best sun protective clothing and sunscreen products will block these wavelengths of UVA radiation.
In 2011, the U.S. Food and Drug Administration (FDA) established a "broad spectrum" test for determining a sunscreen product's UVA protection. Sunscreen products that pass the test are allowed to be labeled as "Broad Spectrum" sunscreens, which protect against both UVA and UVB rays.
There is no equivalent test or FDA-approved labeling for sun protective clothing. Some clothing is labeled with an Ultraviolet Protection Factor (UPF) but test results from Consumer Reports suggest that UPF is an unreliable indicator of UV protection.
If in doubt, consult a dermatologist for specific product recommendations.
Many different topical and oral medications may be used to treat the inflammatory reaction of phytophotodermatitis. A dermatologist may also prescribe a bleaching cream to help treat the hyperpigmentation and return the skin pigmentation back to normal. If the patient does not receive treatment, the affected sites may develop permanent hyperpigmentation or hypopigmentation.
- List of cutaneous conditions
- Photosensitivity in humans
- Stinging plant, plants with hairs that inject poisons
|Wikimedia Commons has media related to Phytophotodermatitis.|
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