Phytophotodermatitis

"Lime disease" redirects here. For the bacterial disease spread by ticks, see Lyme disease.

Phytophotodermatitis
Other namesberloque dermatitis, margarita photodermatitis, lime disease, lime phytodermatitis
Phytophotodermatitis caused by lime juice
SpecialtyDermatology Edit this on Wikidata
Causesphotosensitizer and UV-A light
Differential diagnosisskin burn; allergic contact dermatitis

Phytophotodermatitis, also known as berloque dermatitis,[1][2][3] margarita photodermatitis,[4][5] lime disease[6] or lime phytodermatitis[6] is a cutaneous phototoxic inflammatory reaction resulting from contact with a light-sensitizing botanical agent (such as lime juice) followed by exposure to ultraviolet A (UV-A) light (from the sun, for instance). Symptoms include erythema, edema, blisters (vesicles and/or bullae), and delayed hyperpigmentation. Heat and moisture tend to exacerbate the reaction.

A reaction may be elicited in any person who has been exposed to adequate amounts of both a photosensitizer and UV-A light. Phytophotodermatitis is not an immunologic response; no prior exposure to the photosensitizing agent is required.

The photosensitizing substances found in phototoxic plants belong to a class of chemical compounds called the furanocoumarins, which are activated by long-wavelength ultraviolet (UV-A) light. The most toxic of these organic compounds are the linear furanocoumarins, so called since they exhibit a linear chemical structure. Bergapten and xanthotoxin (also known as methoxsalen), two linear furanocoumarins derived from psoralen, are invariably found in plants associated with phytophotodermatitis.[2]

  1. ^ James WD, Berger TG, Elston DM, eds. (2006). Andrews' Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. p. 32. ISBN 978-0-7216-2921-6.
  2. ^ a b McGovern TW, Barkley TM (2000). "Botanical Dermatology". The Electronic Textbook of Dermatology. 37 (5). Internet Dermatology Society. Section Phytophotodermatitis. doi:10.1046/j.1365-4362.1998.00385.x. PMID 9620476. S2CID 221810453. Retrieved November 29, 2018.
  3. ^ Alikhan A (March 4, 2016). "Berloque Dermatitis". Medscape. Retrieved August 9, 2018.,
  4. ^ Riahi RR, Cohen PR, Robinson FW, Gray JM (June 2009). "What Caused The Rash On This Man's Wrist And Hand?". The Dermatologist. 11 (6).
  5. ^ Abramowitz AI, Resnik KS, Cohen KR (March 1993). "Margarita photodermatitis". The New England Journal of Medicine. 328 (12): 891. doi:10.1056/NEJM199303253281220. PMID 8441448.,
  6. ^ a b Lakshmi Nagireddi, Rachel Raimondo, Robert Hostoffer Jr (January 24, 2022). "Recurrent Bilateral Lime Disease in a Young Female- Case Report". Allergy and Rhinology (Providence). 13. doi:10.1177/21526567221074944. PMC 8796115. PMID 35096464. 21526567221074944. Lime phytodermatitis, also known as margarita dermatitis, is a condition that results in a skin rash after sunlight exposure when handling certain plants. Misdiagnosis is common due to its resemblance to skin burns or allergic contact dermatitis. Detailed history and disease recognition is important to provide accurate treatment recommendations.