P. Treadwell et al. (eds.)Atlas of Adolescent Dermatologyhttps://doi.org/10.1007/978-3-030-58634-8_18

18. Phytophotodermatitis

Patricia Treadwell¹

(1)

Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA

Patricia Treadwell

Email: ptreadwe@iupui.edu

Keywords

PhytophotodermatitisFurocoumarinsHyperpigmentation

18.1 Introduction

Phytophotodermatitis is a dermatitis that occurs following various furocoumarins coming in contact with the skin and subsequent ultraviolet exposure.

18.2 Epidemiology

Phytophotodermatitis can occur at any age. The furocoumarins associated with the dermatitis are found in citrus fruits (especially limes and lemons}, figs, wild dill and parsley, celery, fennel, and parsnip. The hyperpigmentation may be more evident in skin of color.

18.3 Clinical Findings

In milder cases, the cutaneous findings may consist of hyperpigmentation in an unusual pattern. In more severe cases, erythema and tense bullae may develop (Fig. 18.1). The tense bullae may be painful. Itching may be present.

../images/446896_1_En_18_Chapter/446896_1_En_18_Fig1_HTML.jpg — Fig. 18.1
Phytophotodermatitis with erythematous lesions, one with a bulla on the back of the leg after hiking

18.4 Laboratory

No laboratory testing is diagnostic nor necessary.

18.5 Treatment

If the lesions are symptomatic, topical corticosteroids or anti-pruritics can be prescribed.

18.6 Prognosis

The prognosis is generally good, since the hyperpigmentation will fade over time. Unfortunately, some cases have been misdiagnosed as child abuse based on the patterns of the lesions.

Avoiding the offending agents and ultraviolet exposure can minimize future occurrences.