Phytophotodermatitis: causative plants and cross-photosensitivity

Phytophotodermatitis is an acute inflammatory dermatosis of non-immunological nature, resulting from the interaction between photosensitizing substances present in several plant species and subsequent exposure to ultraviolet (UVA) radiation. Clinically, it manifests through erythema, edema, and blister formation, frequently evolving into persistent and difficult-to-manage post-inflammatory hyperpigmentation. The most common etiological agents belong mainly to the Rutaceae, Apiaceae, and Moraceae families, containing furocoumarins that, upon penetrating the epidermis and undergoing photonic activation, induce direct damage to keratinocyte DNA. This study aimed to conduct a systematic review of the literature on frequent causative plants in the Brazilian environment, mechanisms of cross-photosensitivity, and clinical diagnostic and management strategies. The methodology was based on a bibliographic analysis of scientific studies, case reports, and dermatological consensus published in the last decade, prioritizing the identification of the most prevalent phytophotodermatogens. The results show that, in addition to classic citrus species such as lemon, ornamental plants and medicinal herbs used by the Brazilian population play an increasing role as causes of dermatoses in sun-exposed areas. It is concluded that differential diagnosis, often confused with thermal burns or allergic contact dermatitis, is crucial, and patient education on the safe handling of vegetables is the most impactful factor in primary prevention and mitigation of inflammatory conditions. (AU)