Poison Oak, Ivy, Sumac dermatitis
Background
- Type of contact dermatitis
- Caused by Urashiols found in the sap of the plant.
| Plant | Distribution | Charateristics |
| Ivy | East of the Rockies |
|
| Oak | West of the Rockies |
|
| Sumac | Southeast swamps |
|
Clinical Features
- Previous exposure leads to sensitization and earlier symptoms
- 1-2 days for previous sensitizations and 10-14 days for first contact
Differential Diagnosis
Vesiculobullous rashes
Febrile
- Diffuse distribution
- Varicella (chickenpox)
- Smallpox
- Monkeypox
- Disseminated gonococcal disease
- DIC
- Purpural fulminans
- Localized distribution
Afebrile
- Diffuse distribution
- Bullous pemphigoid
- Drug-Induced bullous disorders
- Pemphigus vulgaris
- Phytophotodermatitis
- Erythema multiforme major
- Bullous impetigo
- Localized distribution
- Contact dermatitis
- Herpes zoster (shingles)
- Dyshidrotic eczema
- Burn
- Dermatitis herpetiformis
- Erythema multiforme minor
- Poison Oak, Ivy, Sumac dermatitis
- Bullosis diabeticorum
- Bullous impetigo
- Folliculitis
Evaluation
- Clinical diagnosis
Management
Prophylaxis
Prexposure
- Ivy Shield, Stokogard, Organoclay, or IvyBlock
Postexposure
- Technu Poison Cleanser- may solubilize bound resin several hours post exposure
- Dr Wests Ivy Detox Cleanser chelates urushiol- decreases itching even if have rash
Symptomatic Treatment
- 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
See Also
Video
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