A family brings their 10-year-old daughter to clinic during the summer months. They immigrated from Mexico over the winter. She presents with an eruption on her lips, as seen in the image. She has had similar episodes in prior summers, with involvement of the upper eyelids and distal dorsal arms and hands, as well as associated conjunctivitis. Her symptoms are triggered by sun exposure. She was previously prescribed a medium-potency topical corticosteroid without improvement.

What is the first-line treatment for this condition?

A. Hydroxychloroquine

B. Topical corticosteroids

C. Thalidomide

D. Topical tacrolimus

E. Serial phlebotomy

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