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Special Feature
February 2000

Picture of the Month

Arch Pediatr Adolesc Med. 2000;154(2):202. doi:

Figure 1 and Figure 2. The skin lesions on the trunk conform precisely to the borders of the bathing suit. Bullae and vesicles, some linear in arrangement, are set on an erythematous base. The history revealed that the girl and her siblings had eaten limes, the juice of which had run down onto the chest and abdomen. The children were exposed to sunlight.

Figure 3 and Figure 4. Hyperpigmented patches and macules are present on both arms. The skin lesions appeared shortly after harvesting ornamental oranges.

Phytophotodermatitis refers to a skin eruption that results from the interaction of radiant energy from the sun with photosensitizing compounds found in various plants. These agents that potentially produce phototoxic effects are present in many plant varieties, including several isomers of psoralens (furocoumarins). The psoralens form phototoxic compounds on exposure to UV-A radiation (wavelengths of 320-400 nm).1 The compounds cause direct damage to the DNA of epidermal cells, resulting in reactions that range from macular erythema or hyperpigmentation to blistering lesions, depending on the extent of exposure. The figures show the spectrum of skin reactions that may be seen.

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