Poison Oak, Ivy, Sumac dermatitis

Background

• Caused by Urashiols found in the sap of the plant.

• Ivy
  • East of the Rockies: 3 leaf structure
• Oak
  • West of the Rockies: can be tree bush or vine- jet black stain on leaf, 3 leaf structure
• Sumac
  • Southeast: in swamps- 2 opposing leaflets single terminal leaf

Previous exposure leads to sensitization and earlier symptoms (1-2 days for previous sensitizations and 10-14 days for first contact)

Treatment

Prexposure Prophylaxis

-Ivy Shield, Stokogard, Organoclay, IvyBlock

Postexposure Prophylaxis

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

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

Symtomatic 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