Phototoxic reaction to bakuchi seeds tried as home remedy in
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Patients lure by watching the videos regarding treatment of various diseases, blindly follow their recommendations. It may sometimes lead to disastrous complications. Vitiligo, although a non-communicable disease, is still a social stigma. Such patients are desperate for any treatment which promises quick results. Some of these patients end up applying home-remedies which result in unwanted outcomes.

A 36-year old woman with vitiligo who prepared a home remedy as recommended in a YouTube video for the treatment, developed a phototoxic reaction. She reported with complaints of fluid-filled bullae and redness over white patches of vitiligo for a period of three days associated with pain and burning. The patient had applied a mixture of crushed bakuchi (babchi) seeds and coconut oil and exposed the vitiliginous part to the sun for 5 minutes. Within 30 minutes of sun exposure, she started developing redness, intense pain, and a burning sensation at these sites, followed by the development of bullae over the white patches. She was not on any medications for other ailments.

On examination, erythema was present over pre-existing vitiligo patches on the forehead, neck, arms, and forearms. Multiple tense, turbid looking bullae were noted at the same sites. A diagnosis of phototoxic reaction to bakuchi seeds was made. She was advised to follow strict photoprotection and started on a tapering dose of oral prednisolone, levocetrizine, and a combination of betamethasone and fusidic acid creams for local application. She recovered within one week of starting treatment.

Vitiligo is often associated with social stigma, hence patients are desperate for a quick remedy of the disease. In this case our patient had used bakuchi seeds mixed with coconut oil. Bakuchi is a herbal plant belonging to the genus Psoralea, species corylifolia Linn . Fumarocoumarins of seeds and leaves of the plant which contain psoralen and isopsoralen are highly likely responsible for the phototoxicity in this patient. Its seeds and oil are freely available in India. It is advertised as a blood purifier and is also used in treatment for vitiligo, eczemas, fungal infection, scabies, and leprosy monitored in some way by qualified practitioners. Patients should be discouraged from trying out unsubstantiated home remedies.