Case of the Month

A classic case presented by

Brevin A.D. Clark. MD2B

and
Charles E. Crutchfield III, MD

This patient presented with a rash on his neck after his girlfriend rubbed an ‘essential oil’ on it and he spent several hours working outside on a very sunny day.

What's Your Diagnosis?

Diagnosis: Berloque Dermatitis

A 25-year-old landscaper presented to our clinic with an odd, streaky rash on both sides of his neck. It started four days before our visit, and after his girlfriend (and essential oil hobbyist) rubbed 'oil of Bergamot on his neck. He continued his landscaping activities, without sunscreen. Initially, the rash on the sides of his neck was red and itchy. Then, two days before presentation, the area started developing a brown hue.

Berloque dermatitis is a phototoxic skin reaction. It results from the exposure of the furocoumarin 'bergapten', a type of psoralen (5-methoxypsoralen), to UVA radiation (in sunlight). Bergapten is the only phototoxic agent in the oil of Bergamot, a derivative of the rinds of bergamot limes. In the past, oil of Bergamot was used in many fragrances and perfumes. Berloque dermatitis (French) is also known as Berlock dermatitis (German). The resulting skin changes will slowly fade, but the best strategy is to avoid Bergamot oil or products that contain Bergamot oil.

Reference

https://emedicine.medscape.com/article/1119063-overview