Berloque Dermatitis

Berloque dermatitis occurs when perfume, typically applied to the neck, behind the ears and wrists, containing bergamot oil with furanocoumarins, specifically bergaptene, is subsequently exposed to sunlight or ultraviolet radiation. The clinical presentation is characterized by the appearance of hyperpigmented patches in the areas where the perfume was applied, which persist for several weeks.

Phytophotodermatitis

Phytophotodermatitis develops when the skin comes into contact with plants that can cause phototoxic reactions when exposed to sunlight or ultraviolet light. One of the most common causes is lime juice, which is used in beverages and hair rinses. In areas near water, phytophotodermatitis may be caused by meadow grasses. In areas of skin contact with the plant, erythematous, striated patches resembling leaf and stem impressions and, less commonly, vesicles or blisters with clear contents appear. These eruptions resolve within 7-10 days, leaving pigmented spots.

Diagnosis is based on the patient's history and clinical presentation.

Laboratory Tests

• Complete blood count and urinalysis, blood biochemistry.
• Examination of autoantibody levels in the blood, including antinuclear antibodies, antibodies to double-stranded (native) DNA, Sm, Ro/SS-A, and La/SS-B antigens, etc. (conducted to rule out lupus erythematosus).
• Examination of porphyrin levels in blood plasma, erythrocytes, and urine (conducted to rule out porphyria).

• Chronic actinic dermatitis
• Contact dermatitis
• Eczema
• Lupus erythematosus
• Porphyria cutanea tarda
• Other photodermatoses and diseases whose course may be aggravated by sunlight or ultraviolet light (atopic dermatitis, seborrheic dermatitis, erythema multiforme, etc.).

General Remarks

• Symptomatic therapy is prescribed to alleviate skin eruptions. If blisters are present, they should be drained. Apply cold compresses or wet-dry dressings to areas of erythema and skin swelling.
• Use of moisturizers and topical glucocorticosteroids is recommended, but there is no clear evidence of their effectiveness. For the treatment of acute inflammatory symptoms, glucocorticosteroids are prescribed in form of emulsions, lotions or creams.
• In some cases, antihistamines may be recommended.
• In severe reactions, systemic glucocorticosteroids are used.

Systemic treatment

Antihistamine Medications

• Loratadine 5-10 mg orally once a day for 7-10 days OR
• Cetirizine 5-10 mg orally once a day for 7-10 days OR
• Ebastine 5-20 mg orally once a day for 7-10 days OR
• Levocetirizine 5 mg orally once a day for 7-10 days.

Systemic Glucocorticosteroids

Prednisone 60-80 mg per day orally for several days with subsequent dose reduction until discontinuation.

Topical treatment

Topical Glucocorticosteroids

• Mometasone furoate applied externally 1-2 times a day as applications OR
• Methylprednisolone aceponate applied externally 1-2 times a day as applications OR
• Alclometasone dipropionate applied externally 1-2 times a day as applications OR
• Betamethasone valerate applied externally 1-2 times a day as applications OR
• Betamethasone dipropionate applied externally 1-2 times a day as applications OR
• Fluticasone propionate applied externally 1-2 times a day as applications OR
• Hydrocortisone butyrate applied externally 1-2 times a day as applications OR
• Clobetasol propionate applied externally 1-2 times a day as applications.

Treatment course: 2-4 weeks.

Prevention