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Visual Treats in Dermatology
2023
:3;
69
doi:
10.25259/CSDM_51_2023

Confluent vesicles and bullae arranged in linear streaks

Department of Dermatology and Venereology, Government Medical College, Trivandrum, Kerala, India
Corresponding author: Pradeep S. Nair, Department of Dermatology and Venereology, Government Medical College, Trivandrum, Kerala, India. dvmchtvm@yahoo.co.in
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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Nair PS. Confluent vesicles and bullae arranged in linear streaks. CosmoDerma 2023;3:69.

A 36-year-old female, a fire wood collector residing near a forest area, gave a history of her hand coming in contact with the branches of a shrub in the forest area while collecting fire wood. There was a history of photodermatitis. Within hours, she noticed erythema on the area of contact with burning sensation. The next day, she noticed blisters. On examination, she had well defined and confluent vesicles and bullae arranged in a linear streaks and bizarre pattern extending from the elbow joint to just above the wrist joint of right forearm [Figure 1]. Tzanck smear showed neutrophils and eosinophils. Biopsy showed spongiotic epidermis and the dermis infiltrated with neutrophils and eosinophils. A diagnosis of phytophotodermatitis was made and the patient managed with antibiotics, systemic steroids and topical steroids to which she responded promptly. Phytophotodermatitis occurs due to contact with the branches and secretions of plant species (Anthricus, Ammi majus, and Heracleum) which contains the photosensitizer furocoumarins and on exposure to sunlight phytophotodermatitis occurs.[1] It is now known that anti-cancer drugs and intake of photosensitising drugs can cause phytophotodermatitis without exposure to ultraviolet light after coming in contact with the plants.

Vesicles and bullae arranged in linear streaks and bizarre pattern.
Figure 1:
Vesicles and bullae arranged in linear streaks and bizarre pattern.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Conflicts of interest

There are no conflicts of interest.

Financial support and sponsorship

Nil.

References

  1. , . Occupational contact dermatitis to plants. Clin Dermatol. 1992;10:157-65.
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