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Revista Portuguesa de Medicina Geral e Familiar

versão impressa ISSN 2182-5173

Resumo

TEIXEIRA, Ana Luísa  e  TEIXEIRA, Vera. Phytophotodermatitis: a diagnosis to keep in mind - case report. Rev Port Med Geral Fam [online]. 2021, vol.37, n.4, pp.362-365.  Epub 31-Ago-2021. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v37i4.13083.

Introduction:

Phytophotodermatitis is an inflammatory reaction caused by skin exposure to a photosensitizing plant extract, followed by exposure to ultraviolet radiation. This case report highlights the importance of a well-thought anamnesis as part of the clinical evaluation, as it is the cornerstone for the correct identification of this diagnosis.

Case description:

Male, 59 years old, clinical analysis technician with a history of essential hypertension, medicated and controlled with ramipril 2.5mg, and Fitzpatrick II phototype. The patient came in with a manifestation of linear erythema and discrete vesicular lesions with clear content on the anterior forearms, which he noticed suddenly one morning, the week before. The patient denied itching but felt pain and stinging. He denied knowledge of any triggering factors, known allergies, new cosmetic products or drugs, prolonged sun exposure, and reinforced that there hadn’t been any changes in his daily routine. After more detailed anamnesis the patient mentioned having carried on bare arms, under sunlight exposure, the pruning scraps of his biological agriculture vegetable garden, which included rue. Phytophotodermatitis was therefore diagnosed.

Commentary:

The Rutaceae plant family, in which rue is included, is the second plant family with the most case reports of phytophotodermatitis. This is a clinical diagnosis and therefore the anamnesis is of central importance to identify exposure to potential furocoumarin-containing plants. In this case, the characteristic presentation of painful, non-pruritic, linear erythema and bullae, with the history of exposure to photosensitizing plant extract enabled the diagnosis. Prevention is the best treatment given the limited evidence on the efficacy of topical steroids, antihistamines, and other interventions. Skin hyperpigmentation presents within one or two weeks after exposure and can last for a year.

Palavras-chave : Dermatology; Phototoxic dermatitis; Case reports.

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