A 30-year-old bartender develops bizarre, streaky, hyperpigmented macules and bullae on the dorsum of his hands and forearms a day after squeezing limes and going out in the sun. He denies any pain or itching at onset. What is the most likely diagnosis?
- A Photoallergic contact dermatitis
- B Phytophotodermatitis ✓
- C Polymorphic light eruption
- D Allergic contact dermatitis to lime juice
Correct answer: B. Phytophotodermatitis
Explanation
Phytophotodermatitis is a phototoxic reaction caused by skin contact with furocoumarins (present in limes, celery, figs) followed by UVA exposure. It presents with bizarre, streaky hyperpigmentation and bullae, unlike photoallergic dermatitis which is pruritic and eczematous. Polymorphic light eruption presents with papules and plaques, not streaky patterns, and lacks the preceding plant contact history.
Reference: Bolognia's Dermatology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.