Hyperpigmentation of back of hands due to Phytophotodermatitis secondary to contact with Citrus fruits juice

Background and objective: Peel oil and juice of citrus fruits have furocoumarin (Psoralen) that can induce phytophotodermatitis. If the reaction is mild, then only hyperpigmentation (Without itching, burning, erythema, vesicle and bullae, formation) may occur. The objective of this study was to describe the patients with hyperpigmentation of back of the hands. Materials and Methods: Thirty-two patients with hyperpigmentation of back of hands (Especially between fingers) referred to a dermatologic clinic in Jahrom from 31 December to May 6, 2004, were studied. Results: All of these patients were female and their mean age was 21.4 years. Patients did not complained of itching and burning and there was no history of erythema, vesicle or bullae formation before appearance of hyperpigmentation. 31 patients (97%) took sour orange juice with hands. Out of them, 16 patients (50%) took a lot sour orange juice several days (With mean tine of 7.6 days) before appearance of hyperpigmentation, 8 patients (75%) took only sour orange juice intermittently and 7 patients (22%) took intermittently rough lemon and orange juice in addition to sour orange and only in one patient (3%), the lesions developed about one week after taking rough lemon juice with hands. Conclusion: Phytophotodermatitis secondary to contact with citrus fruit juice may result in hyperpigmentation of back of the hands.