Phytophotodermatitis is an inflammatory skin change that occurs when exposed to chemicals contained in plants. Phytophotodermatitis develops at the site of skin contact with the plant and can manifest itself as redness, erythematous spots, blisters, blisters, necrosis areas. Inflammatory skin changes are usually accompanied by burning, itching or soreness. In the diagnosis, a simple dermatological examination of rashes and the identification of their connection with the effects of plants during the patient’s survey is sufficient. Treatment is carried out by the local use of agitated suspensions, lotions and glucocorticoid ointments, anti-inflammatory and desensitizing drugs.
ICD 10
L23.7 Allergic contact dermatitis caused by plants, other than food
General information
The occurrence of phytophotodermatitis may be due to the effect on the skin of plant juice secreted by leaves and stems, as well as poisonous pollen. The plants that most often cause phytophotodermatitis include: buttercups, hogweed, white ash, primrose, milkweed, nettle, scumpia, sedge, etc. Skin lesions are noted after resting on meadow grasses, walking among tall grass or barefoot. They can have a mass character, for example, during haymaking. In clinical dermatology, there are cases of phytophotodermatitis in furniture production workers associated with certain types of mahogany.
Causes
Substances contained in plants can have irritating, toxic, sensitizing and photosensitizing effects on human skin. Irritating and toxic effects lead to the development of simple contact dermatitis, the manifestations of which occur at the first contact with the plant.
People prone to allergic diseases, such as bronchial asthma, atopic dermatitis, pollinosis, allergic rhinitis, are more susceptible to the occurrence of phytophotodermatitis caused by sensitization of the body with repeated exposure to the skin of substances secreted by plants. In such cases, the disease develops according to the type of allergic contact dermatitis.
Some plant substances are photosensitizers. Their contact with the skin increases its sensitivity to ultraviolet radiation, as a result of which even a short stay in the sun leads to the development of solar dermatitis.
Symptoms
Dermatitis can be manifested by a limited area of diffuse redness of the skin, individual erythematous spots, the appearance of blisters, small vesicles (vesicles) and large blisters (bull). Often, skin lesions resemble a burn caused by exposure to a chemical substance. Less common is phytophotodermatitis with necrotic skin lesions, which is characterized by the formation of erosions and ulcers.
With phytophotodermatitis, inflammatory changes are exposed to areas of the skin that have directly come into contact with the plant or substances secreted by it. Most often these are hands, feet, knees, less often — thighs, face and stomach. Areas of rashes can have a linear character, asymmetric and bizarre shape. They usually cause the patient severe discomfort in the form of burning, soreness or itching.
When resolved, the elements of phytophotodermatitis can leave behind transient or fairly persistent hyperpigmentation. Deeper necrotic changes of the skin, affecting not only the epidermis, but also the dermis, lead to the formation of scars.
Complications
When plant allergens are absorbed through the skin, especially when it is damaged, when inhaling the dust of dried plants or pollen of flowers, allergic conjunctivitis and rhinitis, bronchospastic syndrome, allergic bronchitis, toxicoderma can join the symptoms of phytophotodermatitis. In some cases, severe allergic reactions are possible: Stevens-Johnson syndrome, Layel syndrome, anaphylactic shock.
Diagnostics
The typical clinical picture of phytophotodermatitis and its connection with the effects of plants in the vast majority of cases allow a dermatologist to diagnose at the first examination of the rash. Additionally, it is possible to conduct dermatoscopy, make skin allergic tests with various plant allergens, and in case of infection of rashes, a bacteriological examination of their discharge is possible. Phytophotodermatitis should be differentiated from toxicoderma, urticaria, dermatitis of other genesis, pruritus.
Treatment
The main point in the treatment of phytophotodermatitis is the elimination of the factor that caused it — plants and flowers with which the patient was in contact. In the case of photosensitization, exposure to UV rays of both natural and artificial origin (for example, in a solarium) should be avoided on the affected skin.
Treatment of phytophotodermatitis is carried out mainly locally. Anti-inflammatory agents are used in the form of powders, lotions and shaken suspensions, ointments with corticosteroids. If phytophotodermatitis has an allergic nature, it is necessary to take antihistamines (hifenadine, mebhydroline, loratadine, desloratadine). Pronounced subjective symptoms are an indication for sedative therapy.
