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Phytophotodermatitis to Marrubium Vulgare in a Child
Fatimazahra EL Fatoiki, Afafe Jei*, Fouzia Hali and Soumiya Chiheb
Dermatology Derpatment of IBN Rochd university hospital center, Morocco
Received Date: 17/06/2025; Published Date: 22/05/2025
*Corresponding author: Afafe Jai, Resident at the Dermatology derpatment of Ibn Rochd university hospital center, Casablanca, Morocco
Abstract
The Phytophotodermatitis to Marrubium Vulgare is a skin photosensitization reaction after a contact with Marrubium Vulgare under a solar radiation.
We report a case of a 7-year-old child who had accidentally handled the Marrubium Vulgare during a walk in the fields. The clinical appearance was a skin burn strictly limited to the area of the contact with the plant.
The interest of our observation lies in the ignorance of the photosensitizing caracteristic of Marrubium Vulgare widely used in our context.
Keywords: Phytophotodermatitis; Marrubium Vulgare; Solar radiation; Photosensitization; Phototoxicity
Introduction
Phytophotodermatosis is an abnormal or exaggerated skin reaction following contact with a photosensitizing plant substance in the presence of sunlight exposure. It is most often caused by the presence of furocoumarins in the plant. Here, we report a case of phytophotodermatosis caused by Marrubium Vulgare in a 7-year-old child.
Case Report
A 7-year-old patient, born of non-consanguineous parents, residing in a rural area, with a history of mental retardation, presented with painful blistering lesions on the hands that had been evolving for 4 days. Detailed questioning revealed manipulation of a plant 24 hours before the onset of skin lesions and for several hours under sunlight exposure in the late morning. Dermatological examination revealed dyhidrosiform intraepidermal vesicles on the palms of the hands, with pigmentation at the fingertips suggestive of superficial second-degree burns. The lesions were confined to the palmar surface of the hands, particularly the fingers (Figure 1). Anamnestic investigation identified the implicated plant as Marrubium Vulgare (Figure 2), known for its potent photosensitizing properties. The patient showed improvement after a week of treatment with potent topical corticosteroids and healing cream (Figure 3).
Figure 1: Erythema-bullous pigmented lesions on the palmar surface of the hands.
Figure 2: Causal plant: Marrubium Vulgare.
Figure 3: Evolution of skin lesions after one week of treatment.
Discussion
The uniqueness of our observation lies in the rarity of phytophotodermatosis caused by M. Vulgare and its occurrence in a child during a walk in the fields under late morning sunlight.
Phytophotodermatoses result from cutaneous photosensitization reactions upon contact with a plant substance with sensitizing properties induced by sunlight exposure. There are two types of cutaneous photosensitization reactions: phototoxic reactions and photoallergic reactions [1].
Phototoxic reactions, with a non-immunological mechanism, manifest as skin burns occurring upon the first contact with the plant in the presence of ultraviolet radiation and remain strictly localized to the contact area. On the other hand, photoallergic reactions involve an immuno-allergic response. The antigen is the transformation of the causal plant substance into a photoallergen after light irradiation. This represents a type IV hypersensitivity reaction according to the Gell and Coombs classification and requires prior contact with the photoallergen [2]. Clinically, it presents as contact dermatitis with lesions initially limited to exposed areas and a potential extension to covered areas [3].
Conclusion
In our case, the clinical appearance of skin burns and the strict limitation of lesions to the areas in contact with the plant favor a phytophotodermatosis with a phototoxic mechanism.
Marrubium Vulgare is a plant frequently used in the Mediterranean region for its hypoglycemic, analgesic, antifungal, laxative, and other properties. This plant contains chemical compounds such as psoralen, polyphenols, and coumarins responsible for its photosensitizing power in the presence of sunlight exposure [4]. In our case, the manipulation of this plant was not for therapeutic purposes but rather accidental in a 7- year-old child with mental retardation during a walk in the fields.
Phytophotodermatosis caused by Marrubium Vulgare deserves attention from dermatologists, especially considering the widespread use of this highly photosensitizing plant, often unrecognized by the general population, in our context.
Conflict of interest: None
References
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