Berloque disease

Diagnosis: Berloque disease

Notice the pattern of contact guilty hand

Clinical Presentation

Notice the pattern of contact guilty hand

Clinical History

Submitted by Humberto Cantu Garza. Originally posted October 18, 2012.

Treatment

See case discussion.

Differential Diagnosis

• Contact dermatitis • Child abuse (burn marks) • Berloque dermatitis • Drug-induced photosensitivity • Bullous insect bite reaction • Herpes zoster

Key Learnings

• Phototoxic reaction from furocoumarins (psoralens) in plants + UV exposure • Classic culprits: lime, lemon, celery, parsnip, giant hogweed, fig • "Lime disease" (not Lyme) — classic bartender or vacation scenario • Linear, bizarre-shaped erythema/vesicles followed by dramatic post-inflammatory hyperpigmentation • NOT immune-mediated — phototoxic (anyone will react with sufficient exposure) • Berloque dermatitis: from bergamot oil in perfumes — teardrop hyperpigmentation on neck

Tags: berloque, disease, humberto cantu garza