Phytophotodermatitis

Background

The result of chemicals in certain foods reacting with sunlight to cause an aggrevated "sun-burn" like rash

Common Causative Agents[1]

Celery
Parsnip
Fennel
Lime
Carrot
Mustard
Parley
Dill
Grapefruit
Lemon
Fig
St. John's wort

Clinical Features[2]

Phytophotodermatitis caused by lime

Classic phytophotodermatitis

Severe phytophotodermatitis

Bizarre, linear streaking rash that can be painful or burning
Bullae and vesicles
Often in a "dripping" pattern or with hand-prints
Acute phase 3-5 days, may then progress to hyperpigmentation for months

Differential Diagnosis

Vesiculobullous rashes

Febrile

Diffuse distribution
- Varicella
- Smallpox
- Disseminated gonococcal disease
- DIC
- Purpural fulminans
Localized distribution
- Necrotizing fasciitis
- Hand-foot-and-mouth disease

Afebrile

Diffuse distribution
- Bullous pemphigoid
- Drug-Induced bullous disorders
- Pemphigus vulgaris
- Phytophotodermatitis
- Erythema multiforme major
- Bullous impetigo
Localized distribution
- Contact dermatitis
- Herpes zoster
- Dyshidrotic eczema
- Burn
- Dermatitis herpetiformis
- Erythema multiforme minor
- Poison Oak, Ivy, Sumac dermatitis
- Bullosis diabeticorum
- Bullous impetigo
- Folliculitis

Evaluation

Clinical diagnosis

Management

Topical steroids (e.g. topical triamcinolone)[3]

Disposition

Outpatient

See Also

Rashes

External Links

References

Raam et al. "Phytophotodermatitis: The other lime disease." Annals of EM. April 2016. 67(4):554-556
Raam et al. "Phytophotodermatitis: The other lime disease." Annals of EM. April 2016. 67(4):554-556
Raam et al. "Phytophotodermatitis: The other lime disease." Annals of EM. April 2016. 67(4):554-556

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