It turns out that there is more than one bad type of “lemon disease”. In a recent report, doctors described a man who had swollen and nasty blisters on his hands after juicing a bunch of limes—limes that made his skin more vulnerable to the Sun’s harmful rays.
The man’s doctors reported the case last week at New England Journal of Medicineas part of a regular feature that highlights photos of unusual injuries or illnesses. A 40-year-old man presented to the allergy clinic two days after developing a burning rash running along both hands, especially the fingers and a blister on the left thumb. Apparently it didn’t take long for the doctors to diagnose him when they discovered that the day before his rash started, he had already juiced 12 limes and spent the day outside watching a football game. This man was a classic case of phytophotodermatitis (for those with a strong stomach, the man’s hands can be viewed here).
Phytophotodermatitis is caused by a combination of two factors: exposure to a class of chemicals commonly found in plants and fruits known as furanocoumarins, followed by exposure to ultraviolet A rays. immune system. Unlike sunburn, it can take a day or two for symptoms of phytophotodermatitis to appear after exposure, although the rash is usually mild.
Citrus fruits such as lemons and limes are a common cause of phytophotodermatitis—so much so that doctors have dubbed the disease lemon disease, while others have dubbed it “margarita burn.” Figs, celery, parsley and other culinary plants can cause this condition as well. As funny as it sounds, this condition is dangerous if it causes open skin wounds, because it leaves the door open to secondary skin infections.
Unfortunately, there is no easy way to diagnose phytophotodermatitis once it has occurred; you just have to wait for it to disappear on its own, which can take weeks to months. That said, doctors can prescribe medications that relieve symptoms or the risk of infection.
In this case, the man was given a topical steroid cream and moisturizer for his affected skin. He later developed a blister and scaly skin, but his hands eventually returned to normal after a few months. Things could have been worse for him, as the condition was known to cause red scars that took years to heal. Some people have thought that phytophotodermatitis (especially conditions caused by exposure to the large hogweed plant) can cause blindness, although no actual reports of this problem seem to have been documented.
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