Dr Bo Kristiansen at Department of Pulmonary Medicine, Odense University Hospital, Odense, Denmark and associates have reported a rare case of a bullous eruption of the hands due to Arctic midnight sun. The case has appeared in BMJ Case Reports.
The authors have presented an unusual case of a 29-year-old Australian male visiting Greenland who presented with a severe itchy bullous eruption on his hands. The cause was a combination of exposure to lime fruit juice and prolonged sun exposure from the Arctic midnight sun.
According to history, a 29-year-old tourist from Australia visited Greenland for several weeks. He kept on hiking in midnight sun and also kept on drinking lime bottle during the trip. Two days later, he was surprised to find a severe itchy bullous eruption on his hands. The cause was a combination of exposure to lime fruit juice and prolonged sun exposure from the Arctic midnight sun.
The condition, known as phytophotodermatitis, means “plant” (phyto), “light” (photo) and “skin inflammation” (dermatitis) in Greek. It is caused by the deposition of photosensitising compounds on the skin followed by ultraviolet exposure. It is also known as Berloque dermatitis or margarita photodermatitis.
The symptoms of phytophotodermatitis vary based on the cycle of the reaction. They may be blister-like patches across the skin which are often itchy and irregularly shaped. These patches appear most commonly appear on legs, hands and arms.
The patches can also appear in the form of drips and streaks giving rise to dark pigmentation in place of the blisters which is called post-inflammatory pigmentation. This stage can last for several weeks, or even months.
Limes aren’t the only plant products known to cause phytophotodermatitis. Other citrus plants, as well as celery, figs, meadow grass, wild parsnip, certain weeds — including giant hogweed — and oil of bergamot, contain photosensitizing compounds, the researchers wrote in the case report. “
The doctors lanced and bandaged the man’s blisters, gave him antibiotics to prevent bacterial infections and recommended that he wear gloves to protect his hands from the sunlight. The man later reported that his hands were sore and itchy for another four weeks, but within two months he had largely recovered.
For further reference log on to: BMJ Case Reports 2018; doi:10.1136/bcr-2018-225981