Maj 2011

A 5 year old is brought to the ER because of a break out of a reaction on both hands that looks like a burn.

The day before the child went on a field trip to the forest with the kindergarden.

What diagnose should be considered?

The answer

Diagnose:

Phyto-photo Dermatitis

• Toxic reaction to light after contact with light sensitizing nectar (furocoumarins = psoralenes).
• Typical after contact with Apiaceae or Umbelliferae such as angelica, asafoetida, caraway, carrot, celery, fennel, parsley and Queen Anne's Lace.
• Usually Phyto-photo toxic reactions are developed within 24-48 hours after exposure to the skin.
• It begins with erythema, oedema and a burning sensation. Later comes vesicles and maybe blisters.
• The inflammatory respons peaks at around 72 hours after exposure.
• The dermatitis is limited to the areas of the body that has been exposed to light.

Treatment:

The standard treatment is a potent local steroid. Hyperpigmentation can occur and be present for months maybe years, but it will vanish in time.

Read more in the archive: Fytofotodermatitt