Hyperpigmented blistering lesion in a 13 yo female

Presenter: Michael Kassardjian, Helia Eragi, Teresa Ishak
Dermatology Program: Western University/Pacific Hospital Long Beach
Program Director: Dr. David Horowitz
Submitted on: May 22, 2012

CHIEF COMPLAINT:  Painful blistering rash on body

CLINICAL HISTORY:

Signs and symptoms:  Two day history of painful, hyperpigmented rash with sparse blisters on trunk, upper extremities bilaterally, and flexor surfaces few hours after sun exposure. No past medical history, no family history, patient otherwise healthy. No systemic symptoms

Previous Treatment:  none

Other information:  13 yo caucasian female had recently arranged a spa day where each individual laid out in the sun after applying lemon juice and other citrus plants/fruits to their body. Few hours after the sun exposure, patient started experiencing pain erythematous rash on sun exposed areas as mentioned with sparse blisters.

PHYSICAL EXAM:

The patient exhibited erythematous and hyperpigmented patches, with sparse blisters and vesicles diffusely on the trunk, bilateral upper extremities and flexor surfaces of the lower extremities. Her trunk displayed areas of mild desquamation.

 

 

LABORATORY TESTS:

none

DERMATOHISTOPATHOLOGY:

none

DIFFERENTIAL DIAGNOSIS:

1.   Phytophotodermatitis
2.   contact dermatitis
3.   thermal burn
4.   porphyria cutanea tarda
5.   chemical burn


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