# Rash and Fever: Identifying Animal or Plant Origins

## TL;DR

This paper discusses a skin condition caused by plant chemicals and UV light, highlighting the importance of accurate diagnosis to avoid unnecessary treatment.

## Contribution

The paper emphasizes the need for detailed clinical history and physical examination in diagnosing phytophotodermatitis.

## Key findings

- Phytophotodermatitis can present with rash and fever, often misdiagnosed as other dermatological conditions.
- A skin biopsy and clinical history confirmed phytophotodermatitis with secondary bacterial infection in a patient.
- Treatment with antibiotics and corticosteroids resolved symptoms, and non-pharmacological measures were advised.

## Abstract

Phytophotodermatitis is a dermatological condition resulting from exposure of the skin to furanocoumarins and subsequent exposure to ultraviolet radiation. It has been described mainly after direct contact with plants but also with their extracts, particularly limes, lemons, figs, celery, or parsley. The clinical presentation is variable and may range from asymptomatic to erythematous rash, which may progress into vesicles or bullae. The main differential diagnoses are contact dermatitis, allergic dermatitis, and burns. The diagnosis is based on clinical history, clinical findings, and physical examination. In such cases, accurate diagnosis is necessary to avoid unnecessary treatment. We present the case of a 55-year-old patient with recurrent episodes of pruritus who presented with a new rash and fever. After a review of the aetiology and clinical history, supported by a skin biopsy, a diagnosis of phytophotodermatitis with secondary bacterial infection was made. After treatment with antibiotics and corticosteroids, the symptoms disappeared, and a non-pharmacological approach was recommended. The aim of this article is, therefore, to emphasize the significance of this disorder, to raise awareness of it, and to emphasize the importance, in an increasingly technological age, of a detailed clinical history and physical examination as the main tool for a correct diagnosis.