Phytophotodermatitis is a cutaneous phototoxic eruption caused by the interaction of furocoumarins found in some common plants with solar UVA radiation. It is a common skin complaint in travelers to tropical regions. Approximately 24 hours after plant contact with subsequent exposure to sunlight, a burning erythema develops. Limes, other citrus fruits, celery, figs, meadow grass, certain weeds, and oil of bergamot are frequently causative. Exposure to the plant sap of wild parsnip (Pastinaca sativa; "poison parsnip"), common throughout the United States, can cause severe phytophotodermatitis (when in bloom it looks similar to Queen Anne's lace or dill plant and grows to around 4 feet tall). Common scenarios include squeezing limes outdoors, gardening and agricultural work, and hiking or biking in areas of causative plants.
There is no predilection for any age or ethnicity or either sex, although phytophotodermatitis may be more noticeable in lighter skin phototypes. Bartenders and revelers handling citrus fruits are at higher risk. The condition is benign and self-limited, and treatment is supportive.
The term "Berloque dermatitis" refers to phytophotodermatitis from natural oil of bergamot in perfumes. This eruption is typically seen on the face and neck of women applying aerosolized fragrances. This has become rare since the introduction of artificial oil of bergamot.
Phytophotodermatitis is a skin reaction due to sun exposure (ultraviolet radiation) following contact with certain plants containing furocoumarins. These include fennel, figs, carrots, celery, parsley, wild parsnip, oil of bergamot, limes, Persian limes, lemons, oranges, other citrus plants, and certain weeds, such as hogweed and Queen Anne's lace (also called wild carrot). Contact can be made during agricultural work, outdoor gardening, hiking, and outdoor dining.
A burning, red, sometimes blistering skin reaction can occur about 24 hours after exposure to plants and sunlight.
Although unpleasant, phytophotodermatitis commonly goes away on its own. Dark patches may last months to years.
Who’s At Risk
Phytophotodermatitis can occur in adults or children, male or female, and of any race or ethnicity. Persons handling citrus fruits and beverages, citrus grove and celery workers, and others exposed to sunlight and furocoumarin-containing plants are more likely to develop this skin reaction.
Tropical and subtropical regions have a greater occurrence of cases of phytophotodermatitis.
Signs & Symptoms
Phytophotodermatitis looks like burning, red, and sometimes blistering skin where it came in contact with limes, citrus, figs, or other furocoumarins followed by exposure to sunlight. Skin may be painful, itchy, swollen, and darkened. The skin reaction may appear in lines, streaks, angular patches, or strange configurations.
This reaction can occur within 24-48 hours of exposure.
Avoid plant and citrus contact with skin. Use adequate sunscreen and protective clothing to prevent the reaction.
Symptoms may be relieved with cool compresses or soaking in cool water.
When to Seek Medical Care
For severe reactions that persist or to rule out other causes, contact your doctor.