Toxicodendron Poisoning Follow-up

  • Author: Steven L Stephanides, MD; Chief Editor: Asim Tarabar, MD   more...
 
Updated: Apr 19, 2011
 

Further Outpatient Care

  • Patients should follow up with their primary care physician.
  • All contaminated clothing and articles should be washed. Pets that have been exposed should be bathed well to remove the oil from their fur.
  • Precautions include watching for secondary bacterial infection of skin lesions.
Next

Deterrence/Prevention

  • Avoid exposure.
  • Protective clothing, such as gloves (nonlatex), should be worn if handling the plants or contaminated objects or animals.
  • A number of barrier creams are available. Although they cannot completely eliminate the reaction, they can significantly diminish the exposure.
Previous
Next

Complications

  • Superinfection of skin lesions
  • Hyperpigmentation of healing lesions (usually resolves spontaneously within a few weeks)
Previous
Next

Prognosis

  • Complete resolution is expected within 7-21 days.
Previous
Next

Patient Education

  • Instruct the patient that the fluid from the bullae is not an irritant and cannot extend the rash.
  • If steroids have been given, caution the patient on the risks of rebound flare if steroid therapy is stopped prematurely.
  • For excellent patient education resources, visit eMedicine's Allergy Center. Also, see eMedicine's patient education article Allergy: Poison Ivy, Oak, and Sumac.
Previous
 
Contributor Information and Disclosures
Author

Steven L Stephanides, MD  Attending Physician, Department of Emergency Medicine, Eisenhower Medical Center

Steven L Stephanides, MD is a member of the following medical societies: American College of Emergency Physicians, National Association of EMS Physicians, Society for Academic Emergency Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Coauthor(s)

Chris Moore, PhD, MD  Medical Director, Department of Emergency Medicine, Virginia Mason Medical Center

Chris Moore, PhD, MD is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Miguel C Fernandez, MD, FAAEM, FACEP, FACMT, FACCT  Associate Clinical Professor; Medical and Managing Director, South Texas Poison Center, Department of Surgery/Emergency Medicine and Toxicology, University of Texas Health Science Center at San Antonio

Miguel C Fernandez, MD, FAAEM, FACEP, FACMT, FACCT is a member of the following medical societies: American Academy of Emergency Medicine, American College of Clinical Toxicologists, American College of Emergency Physicians, American College of Medical Toxicology, American College of Occupational and Environmental Medicine, Society for Academic Emergency Medicine, and Texas Medical Association

Disclosure: Nothing to disclose.

John T VanDeVoort, PharmD  Regional Director of Pharmacy, Sacred Heart & St. Joseph's Hospitals

John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists

Disclosure: Nothing to disclose.

Michael Hodgman, MD  Assistant Clinical Professor of Medicine, Department of Emergency Medicine, Bassett Healthcare

Michael Hodgman, MD is a member of the following medical societies: American College of Medical Toxicology, American College of Physicians, Medical Society of the State of New York, and Wilderness Medical Society

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Asim Tarabar, MD  Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital

Disclosure: Nothing to disclose.

References

  1. Leclercq RM. [Severe contact-allergy dermatitis due to poison ivy--a plant that is rarely encountered in The Netherlands; a family history]. Ned Tijdschr Geneeskd. Jul 23 2005;149(30):1697-700. [Medline].

  2. Gach JE, Tucker W, Hill VA. Three cases of severe Rhus dermatitis in an English primary school. J Eur Acad Dermatol Venereol. Feb 2006;20(2):212-3. [Medline].

  3. Thoo CH, Freeman S. Hypersensitivity reaction to the ingestion of mango flesh. Australas J Dermatol. May 2008;49(2):116-9. [Medline].

  4. Canavan D, Yarnell E. Successful treatment of poison oak dermatitis treated with Grindelia spp. (Gumweed). J Altern Complement Med. Aug 2005;11(4):709-11. [Medline].

  5. [Guideline] Contact dermatitis: a practice parameter. Ann Allergy Asthma Immunol. Sep 2006;97(3 Suppl 2):S1-38. [Medline].

  6. Botanical dermatology: allergic contact dermatitis. Electronic Textbook of Dermatology. Available at http://telemedicine.org/botanica/bot6.htm. Accessed June 16, 2007.

  7. Cardinali C, Francalanci S, Giomi B, et al. Contact dermatitis from Rhus toxicodendron in a homeopathic remedy. J Am Acad Dermatol. Jan 2004;50(1):150-1. [Medline].

  8. Chapel TA, Chapel J. Toxicodendron dermatitis. In: Emergency Medicine - A Comprehensive Study Guide. 4th ed. 1996:1111-1113.

  9. Davila A, Laurora M, Fulton J. A New Topical Agent, Zanfel, Ameliorates Urushiol-Induced Toxicodendron Allergic Contact Dermatitis. Ann Emerg Med. 2003;42(4 supp 1):Abstract no 364; s98.

  10. Epstein WL. The poison ivy picker of Pennypack Park: the continuing saga of poison ivy. J Invest Dermatol. Mar 1987;88(3 Suppl):7s-11s. [Medline].

  11. Epstein WL. Topical prevention of poison ivy/oak dermatitis. Arch Dermatol. Apr 1989;125(4):499-501. [Medline].

  12. Epstein WL, Epstein JH. Plant-induced dermatitis. In: Auerbach PS, ed. Wilderness Medicine. 4th ed. Mosby; 2001:1088-1107.

  13. Oh SH, Haw CR, Lee MH. Clinical and immunologic features of systemic contact dermatitis from ingestion of Rhus (Toxicodendron). Contact Dermatitis. May 2003;48(5):251-4. [Medline].

  14. Orchard SM, Fellman JH, Storrs FJ. Topical substances which prevent poison ivy allergic contact dermatitis. Acta Derm Venereol Suppl (Stockh). 1987;134:103-6. [Medline].

  15. Sasseville D. Clinical patterns of phytodermatitis. Dermatol Clin. Jul 2009;27(3):299-308, vi. [Medline].

  16. Stibich AS, Yagan M, Sharma V, Herndon B, Montgomery C. Cost-effective post-exposure prevention of poison ivy dermatitis. Int J Dermatol. Jul 2000;39(7):515-8. [Medline].

  17. Tanner TL. Rhus (Toxicodendron) dermatitis. Prim Care. Jun 2000;27(2):493-502. [Medline].

  18. Williford PM, Sheretz EF. Poison ivy dermatitis. Nuances in treatment. Arch Fam Med. Feb 1994;3(2):184-8. [Medline].

  19. Wooldridge WE. Acute allergic contact dermatitis. How to manage severe cases. Postgrad Med. Mar 1990;87(4):221-4. [Medline].

 
Previous
Next
 
Forearm approximately 10 days after exposure to poison ivy in a garden. Note vesicles and linear areas of the rash.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.