With Valentine’s Day coming up, it reminds me of an all too familiar diagnosis in my dermatology practice. While common to me, especially since I am based in sunny SoCal, it is probably a diagnosis few people know can actually happen!
Late one Sunday evening, I was paged by a very upset, panicked female patient who requested an emergency appointment. She had just returned from a romantic Valentine's Day weekend getaway with her significant other, and was scheduled for a photo shoot the following day.
The patient presented with redness and blistering on her lips, and the skin around her upper lip. She was understandably in a state of panic because she needed the blisters and redness to disappear before her photo shoot. However, she was extremely upset at her partner, and outraged that her partner had transmitted oral herpes to her while they were on vacation.
Upon examination, I told her it was a bad news, good news situation. Bad news - she needed to move the date of her photo shoot date. Good news - she was not suffering from the herpes simplex virus, but a chemical burn called Phytophotodermatitis.
You see, what most people don’t know is that citrus fruits, such as limes and lemons, can cause sun-induced skin sensitivity. Skin that is exposed to citrus juices, then get exposed to the sun, can result is a red rash and/or blistering that shows up 24-48 hours after exposure. The severity of the blisters depends on how long you were in the sun. In this case, the patient’s lips were exposed to lime juice from the margaritas she was enjoying on the beach.
The best way to prevent Phytophotodermatitis is to always wash off areas of your skin that have been exposed to citrus juice, and as always, practice sun safety. Always wear Broad Spectrum Sunscreen of at least SPF 30, and remember to reapply every 2-3 hours when outdoors. Take shade under a large umbrella or canopy, and be sure to take extra precautions with a wide-brim hat and sunglasses.
Lesson learned - when life gives you lemons, don’t squeeze them outdoors.