Over the last few weeks, I have written quite a few articles about caipirinha. I have shared with you all the joy of caipirinha mixing, so it’s only fair that I also warn you about a potential sorrow. As you know, the classic caipirinha recipe contains lime, but what you might not know is that lime juice and ultraviolet radiation is a nasty mix, which you don’t want on your skin.
When summer arrives the number of patients in the clinic with skin burns caused by contact with lemon or other citric fruits increases considerably. Phytophotodermatitis (a.k.a Lime Disease) is very common this time of year, due to increased sun exposure. It is caused by the use of photosensitizer substances generally containing furocoumarins 5-methoxypsoralen (found in some plants, figs, and limes) in combination with exposure to ultraviolet radiation.
The scenario is almost always the same. Someone spent the day at the beach or at the pool cutting limes and preparing cocktails under the sun. By the end of the afternoon, they notice that something just isn’t right and begin to feel their hands itching. By the middle of the night, the itching my turn into a burning, and by the next day, there might be blisters and stains that will take months to disappear.
I actually was witness to something like this many years ago at our beach house near Rio. One of our guests spent the entire day preparing caipis at the beach and by night she had horrible blisters on her hand and could not sleep because of the pain. Of course, her situation was magnified by the blazing Brazilian sun, but you should be very careful nevertheless.
The clinical picture is characterized by an inflammatory reaction in the skin with consequent appearance of reddish spots accompanied by burning or itching, and in severe cases, blisters that develop into dark spots (hyperpigmentation). The shape of the spots will vary in each case. The areas most often affected are the hands and arms. Sometimes stains may take the form of fingers, appearing elsewhere in the body such as the trunk or back, by contact with the hand of another person. Neck burns are also common due to the use of citric perfumes.
Keep in mind that limes and other citrus fruits are not the only cause of burns, some products like perfume can also be dangerous. The diagnosis is made after reporting contact with any substance containing furocoumarins and subsequent exposure to the sun. Usually, patients will confirm that they were at the beach or pool and had manipulated lime, persian lime, fig, among other fruits.
To prevent Phytophotodermatitis you should avoid contact with limes, drinking lemonade, or caipirinhas while directly exposed to sunlight. It is also indicated to avoid using perfume before going to the beach. If you notice any signs of redness, consult a dermatologist for monitoring and evaluation of your burn. The treatment can be done with the base of ointments and corticosteroids moisturizers. Should protect the site with sunscreen and if necessary, depigmenting substances (bleaching) can be used to accelerate improvement. Remember to never burst the bubbles formed!