A Phytophototoxic Injury at a Burns Unit: The Ungraceful After-Effects of the "Common Rue" Plant

Phytophototoxic burn injuries refer to dermal loss after contact with light-sensitizing plants and subsequent exposure to sunlight, which can at their most severe result in full-thickness burns. Phytophototoxic injuries secondary to the Herb of Grace, otherwise known as Ruta Graveolens or the "Common rue" plant, are very rare. The authors report the first case to have been referred directly and solely managed in a specialist burns unit along with a review of the literature. The authors report a case of a 50-year-old gentleman who suffered a phytophototoxic burn injury to his hand 2 days after contact with the "common rue." Unaware of the exacerbating effects of further sun exposure, this gentleman presented with skin loss and was treated conservatively with dressings. The authors would advocate that phytophototoxic injuries secondary to the "Common Rue," which result in skin loss in special anatomical areas including the hands, feet, face, or genitalia, should be referred to a specialist burns care service to ensure that they are appropriately managed. The delay in presentation makes it vital for Burns and Plastic Surgeons treating these injuries to be aware of this plant and consider it in their differential diagnosis. Due to its widespread presence, it remains paramount to provide patient education regarding the use of appropriate protective wear and avoidance of sun for 48 hours postinjury in order to prevent exacerbation of symptoms after the initial exposure.