Accidental bullous phototoxic reactions to bergamot aromatherapy oil

Oil of bergamot is an extract from the rind of bergamot orange (Citrus aura ntium ssp bergamia) that has a pleasant, refreshing scent; until a few year s ago it had been widely used as an ingredient in cosmetics but was restric ted or banned in most countries because of certain adverse effects. More re cently, oil of bergamot preparations have been gaining renewed popularity i n aromatherapy. Oil of bergamot possesses photosensitive and melanogenic pr opel ties because of the presence of furocoumarins, primarily bergapten (5- methoxypsoralen [5-MOP]). However, 5-MOP is also potentially phototoxic and photomutagenic. Despite its increasing application, there are only a few r ecent reports of phototoxic reactions to bergamot aromatherapy oil. We desc ribe two patients with localized and disseminated bullous phototoxic skin r eactions developing within 48 to 72 hours after exposure to bergamot aromat herapy oil and subsequent ultraviolet exposure. One patient (case 2) had no history of direct contact with aromatherapy oil but developed bullous skin lesions after exposure to aerosolized (evaporated) aromatherapy oil in a s auna and subsequent UVA radiation in a tanning salon. This report highlight s the potential health hazard related to the increasing use of psoralen-con taining aromatherapy oils.