Endemic "Lime" Disease: Phytophotodermatitis in San Diego County

Abstract

Phytophotodermatitis is an acute phototoxic skin eruption which often occurs after contact with certain fruits or plants in association with sun exposure. Due to the bizarre configurations of lesions induced by phytophotodermatitis, it can be confused with many other diseases. We present 10 cases with illustrative histories of children with misdiagnosed phytophotodermatitis seen during a 15-month period. All patients were referred for pediatric dermatology evaluation with incorrect diagnoses, and a history was elicited of contact with limes or lemons and sun exposure. The dermatitis mimicked a variety of different diseases. We discuss the peculiar findings of this entity and illustrate its various manifestations.