Berloque (a pendant) dermatitis is skin pigmentation due to phototoxic reaction to perfumes applied to the skin. Berloque dermatitis is considered a special form of phytophotodermatitis.
The reaction occurs commonly on the neck (hence the name berloque) and face. The acute inflammatory dermatitis due to berloque dermatitis might be unnoticed thus the patient presents with the streaky pigmentation. If the inflammatory phase is severe, bullae are formed. The distribution of the lesions is variable (and here it is on the upper limb) but their configuration is usually distinctive. Deep‐brown pigmentation follows the pattern formed by the trickle of the droplets of perfume over the skin from their points of application.
Berloque dermatitis results from the potentiating of UV‐stimulated melanogenesis by 5‐methoxypsoralen (bergapten) in perfumes containing bergamot oil. If a fragrance containing this 5-methoxypsoralen (or another furocoumarin) is applied to the skin before exposure to the sun or tanning lights, berloque dermatitis may result. There are guidelines limiting the use of furocoumarins in some places. There is wide variation in susceptibility. This variation depends on the readiness with which the bergapten is absorbed, the quantity applied, and the intensity and duration of exposure to UV light. Susceptibility is increased by stripping the horny layer. Hot humid conditions favour absorption. The pigmentation occurs in susceptible subjects who have been exposed to light after the application of perfume. Some regulations restrict the concentration of bergapten so that it is below the threshold required to cause dermatitis/pigmentation.
The reaction fades gradually over weeks to months. Sunscreens protect the skin from further sun exposure. If tinted, they can also disguise the lesions.
The child used to apply her mother’s perfume on the left upper limb.
This page was last updated in August 2016.