Poison Oak, Ivy, Sumac dermatitis

Background

- ivy found east coast- 3 leaf structure

- oak- along Pacific Coast can be tree bush or vine- jet black stain on leaf, 3 leaf structure

- sumac- in swamps- 2 opposing leaflets single terminal leaf

-Mango and Cashews can cross react

- toxicodendron- antigen is urushiole

- T- cell mediated delayed hypersensitivity

- resin carried by smoke of burning leaves

- resin found in leaves and stems- not surface

- must break or crush to release resin

- resin binds in 30sec. After binds cannot wash off

- lesions start in 48hrs

- linear array of vesicles

- vesicle fluid not antigenic

-Ivy Shield, Stokogard, Organoclay, IvyBlock

-Technu Poison Cleanser- may solubilize bound resin several hours post exposure

-Dr Wests Ivy Detox Cleanser chelates urushiol- decreases itching even if have rash

if small can use topical Temovate 0.05%
topical anesthetic- menthol or pramoxine
single IM dose of Triamcinolone or Prednisone taper over 15-20 days
- 60mg x 4d then 50mg x 4d then 40 30 20....Use oral steroid for 3wks until skin turns over
systemic antihistamines
cooling soothing baths
Pentoxifylline- blocks formation of TNF alpha- suppresses allergic patch testing
Put sunscreen first, then prexposure ivy cream, then mosquito repellant

6/06 MISTRY

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