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Many affected children also develop very painful bullae and calluses on the soles of the feet and, less commonly, on the palms of the hands Limbs, and hands / feet Phytophotodermatosis (figure 44) Is caused by a reaction between contact with naturally occuring plant psoralens , eg common hogweed, giant hogweed, cow parsnip, and UV exposure The blistering rash, which is often streaky , arises some 24 hours later Refer to the chapter Photodermatoses: drug/chemical-induced Erythema mulitforme (figures 45-46) The lesions are symmetrical and first seen on the backs of hands and / or dorsal aspects of the feet , and then spread along the limbs towards the trunk

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Almost instantly, he is in a daze and falls on his bed