{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:36:48Z","timestamp":1789479408417,"version":"build-2803163510"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"9-10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,29]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Dermatological complaints constitute a large portion of patient visits to both emergency departments and military clinics. Proper assessment to separate the benign diagnoses from life-threatening may prove challenging based on seemingly non-specific history and physical examination. Similarly, reflexive specialty consultation may delay treatment and overload the health care system. Phytophotodermatitis is caused by contact with sensitizing agents, including lime juice, which triggers localized skin reactions when exposed to ultraviolet A light. The resulting progression of erythema, edema, pain, and non-pruritic skin lesions presents a unique pattern limited to the area of initial psoralen contact. This uniquely limited pattern coupled with specific historical context provides evidence for diagnosis. We highlight the case of a 24-year- old otherwise healthy female returning from a leisure trip to Mexico with progressive worsening of erythematous bullae limited to her hands and wrists bilaterally, ultimately attributed to phytophotodermatitis from lime wedge exposure in her alcoholic beverages, commonly referred to as \u201cMexican Beer Hand.\u201d Despite the severity of her initial appearance, her symptoms resolved without complication from limited supportive care.<\/jats:p>","DOI":"10.1093\/milmed\/usac130","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T17:55:40Z","timestamp":1652896540000},"page":"3233-3235","source":"Crossref","is-referenced-by-count":1,"title":["Corona, Lime, Sun, Rash: A Case Report of Severe Phytophotodermatitis in an Active Duty Soldier"],"prefix":"10.1093","volume":"188","author":[{"given":"Brandon M","family":"Carius","sequence":"first","affiliation":[{"name":"Madigan Army Medical Center , Joint Base Lewis-McChord, WA 98413, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel E","family":"Bridwell","sequence":"additional","affiliation":[{"name":"160th Special Operations Aviation Regiment , Joint Base Lewis-McChord, WA 98413, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Hawkins","sequence":"additional","affiliation":[{"name":"135th Forward Resuscitative Surgical Team, Camp Humphreys , APO, AP 96273, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,5,18]]},"reference":[{"issue":"4","key":"2023083018173088900_R1","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1111\/ajd.12130","article-title":"Which patients with dermatological conditions are admitted via the emergency department?","volume":"55","author":"Lai-Kwon","year":"2014","journal-title":"Australas J Dermatol"},{"issue":"4","key":"2023083018173088900_R2","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.jemermed.2016.10.027","article-title":"Rash decisions: an approach to dangerous rashes based on morphology","volume":"52","author":"Santistevan","year":"2017","journal-title":"J Emerg Med"},{"issue":"1","key":"2023083018173088900_R3","article-title":"Epidemiologic characteristics of patients admitted to emergency department with dermatological complaints; a retrospective cross sectional study","volume":"7","author":"Kilic","year":"2019","journal-title":"Arch Acad Emerg Med"},{"issue":"9","key":"2023083018173088900_R4","doi-asserted-by":"crossref","first-page":"882","DOI":"10.7205\/MILMED.173.9.882","article-title":"Evaluation of dermatologic conditions by primary care providers in deployed military settings","volume":"173","author":"Arnold","year":"2008","journal-title":"Mil Med"},{"issue":"12","key":"2023083018173088900_R5","doi-asserted-by":"crossref","DOI":"10.1056\/NEJM199303253281220","article-title":"Margarita photodermatitis","volume":"328","author":"Abramowitz","year":"1993","journal-title":"N Engl J Med"},{"issue":"3","key":"2023083018173088900_R6","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1097\/01.JAA.0000442705.41341.3a","article-title":"What is this streaky rash?","volume":"27","author":"Shah","year":"2014","journal-title":"JAAPA"},{"issue":"2","key":"2023083018173088900_R7","doi-asserted-by":"crossref","first-page":"398","DOI":"10.3122\/jabfm.2021.02.200382","article-title":"Margarita burn: recognition and treatment of phytophotodermatitis","volume":"34","author":"Maniam","year":"2021","journal-title":"J Am Board Fam Med"},{"key":"2023083018173088900_R8","article-title":"Phytophotodermatitis: still a poorly recognised diagnosis","volume":"2018","author":"Mateus","year":"2018","journal-title":"BMJ Case Rep"},{"issue":"4","key":"2023083018173088900_R9","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/j.annemergmed.2016.02.023","article-title":"Phytophotodermatitis: the other \u201clime\u201d disease","volume":"67","author":"Raam","year":"2016","journal-title":"Ann Emerg Med"},{"issue":"6","key":"2023083018173088900_R10","doi-asserted-by":"crossref","first-page":"657","DOI":"10.7205\/MILMED-D-01-7208","article-title":"Phytophotodermatitis: bulla formation and hyperpigmentation during spring break","volume":"174","author":"Kung","year":"2009","journal-title":"Mil Med"},{"issue":"10","key":"2023083018173088900_R11","doi-asserted-by":"crossref","DOI":"10.1503\/cmaj.140942","article-title":"Phytophotodermatitis from making sangria: a phototoxic reaction to lime and lemon juice","volume":"187","author":"Mioduszewski","year":"2015","journal-title":"CMAJ"},{"issue":"1","key":"2023083018173088900_R12","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMicm053778","article-title":"Images in clinical medicine. phytophotodermatitis and limes","volume":"357","author":"Pomeranz","year":"2007","journal-title":"N Engl J Med"},{"issue":"11","key":"2023083018173088900_R13","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1093\/omcr\/omz113","article-title":"Lime-induced phytophotodermatitis","volume":"2019","author":"Abugroun","year":"2019","journal-title":"Oxf Med Case Rep"},{"issue":"12","key":"2023083018173088900_R14","first-page":"938","article-title":"Phytophotodermatitis: rash with many faces","volume":"63","author":"Harshman","year":"2017","journal-title":"Can Fam Physician"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/188\/9-10\/3233\/51307663\/usac130.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/188\/9-10\/3233\/51307663\/usac130.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T18:17:49Z","timestamp":1693419469000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/188\/9-10\/3233\/6588227"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,18]]},"references-count":14,"journal-issue":{"issue":"9-10","published-online":{"date-parts":[[2022,5,18]]},"published-print":{"date-parts":[[2023,8,29]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usac130","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,9,1]]},"published":{"date-parts":[[2022,5,18]]}}}