Toxicodendron Poisoning Workup

Updated: Jan 03, 2017
  • Author: Steven L Stephanides, MD; Chief Editor: Asim Tarabar, MD  more...
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Workup

Approach Considerations

Toxicodendron dermatitis is a clinical diagnosis. Laboratory testing is usually not necessary as part of the emergency department evaluation.

Patch testing is discouraged for toxicodendron dermatitis because it might sensitize an unsensitized individual. However, if contact dermatitis is being considered, patch testing for other allergens might be considered.

Leaf spray mass spectrometry, which is a new ambient ionization method, can detect allergenic urushiols directly from poison ivy with no sample preparation; the results show all the urushiols reported using liquid chromatography mass spectrometry methods. The identifications were confirmed with tandem mass spectrometry analysis of the leaf spray ions. Enhanced detection of some urushiols was achieved in the negative mode if chloride anions were added to the spray solvent. [8] This technique, although not yet readily available, has been used to confirm the diagnosis of black-spot poison ivy, which may clinically resemble melanoma. [5]