A Case of Unilateral Hyperpigmentation

Phytophotodermatitis is a cutaneous phototoxic reaction resulting from contact with plant compounds such as furocoumarin in citrus fruits, followed by exposure to ultraviolet light. Erythema and vesicles appear on the contact area, followed by hyperpigmented lesions. Hyperpigmentation may exist for weeks to months before fading but can remain up to several years. Diagnosis is often challenging due to the variety of clinical presentations, and it is not always easy to identify trigger exposures. A detailed history is key to diagnosis. We herein report a case of lime-induced phytophotodermatitis which was initially mistaken for unilateral lentiginosis. The patient underwent Q-switched Nd:YAG laser and intense pulsed light (IPL) treatment with immediate improvement.

Bacteria-specific phototoxic reactions triggered by blue light and phytochemical carvacrol

Development of alternatives to antibiotics is one of the top priorities in the battle against multidrug-resistant (MDR) bacterial infections. Here, we report that two naturally occurring nonantibiotic modalities, blue light and phytochemical carvacrol, synergistically kill an array of bacteria including their planktonic forms, mature biofilms, and persisters, irrespective of their antibiotic susceptibility. Combination but not single treatment completely or substantially cured acute and established biofilm-associated Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus infections of full thickness murine third-degree burn wounds and rescued mice from lethal Pseudomonas aeruginosa skin wound infections. The combined therapy diminished bacterial colony-forming units as high as 7.5 log10 within 30 min and introduced few adverse events in the survival of cocultured mammalian cells, wound healing, or host DNA. Mechanistic studies revealed that carvacrol was photocatalytically oxidized into a series of photoreactive substrates that underwent photolysis or additional photosensitization reactions in response to the same blue light, forming two autoxidation cycles that interacted with each other resulting in robust generation of cytotoxic reactive oxygen species. This phototoxic reaction took place exclusively in bacteria, initiated by blue light excitation of endogenous porphyrin-like molecules abundantly produced in bacteria compared with mammalian cells. Moreover, no bacterial resistance developed to the combined treatment after 20 successive passages. This highly selective phototoxic reaction confers a unique strategy to combat the growing threat of MDR bacteria.

Essential Oils & Burns: A Case Report of Second Degree Burns Following Bergamot Oil Application and Ultra-Violet A Ray Exposure

Over the past decade there has been a dramatic increase in the consumption of complementary and alternative medicine. The market for supplements and topical agents has grown, with recent reports estimating its value at 6.63 billion dollars. As more consumers utilize these largely unregulated products, it follows that healthcare providers will encounter new injury patterns related to them. Here we will discuss the evaluation and management of phototoxic reaction injuries sustained in a healthy 25-year-old female as a result of exposure to essential oils in the setting of ultra-violet A radiation.