This describes an allergic skin reaction to a specific substance such as poison ivy, oak, or sumac.  It can also be caused by clothing, dyes, soaps, cosmetics, toys, nickel ornaments, and occupational materials which are ordinarily well tolerated by the average individual.

A rash occurs hours to days after contact causing itching, blistering, and hard elevations.  When the blisters break the skin often becomes raw and swollen.  Later, the skin becomes dry and thickened, then returns to its normal state.

The location of the rash may suggest its cause.  For example, brushing against twigs or leaves of poison ivy will cause linear streaking of the rash on exposed areas.

Plant contact dermatitis rash develops 6 hours to 6 days (average 48 hours) after contact with the plant sap from a broken leaf or stem.  It reaches its peak in 5 days with redding, swelling or blistering and can last 1-3 weeks, averaging 2 weeks.  The thinner skin of the groin and face allow easier penetration than the thick skin of the hands.  This explains why these unexposed areas are often more severely affected while the hands are relatively free.

Contrary to popular belief, fluid from the blister will not spread the rash to other parts of the body or other people.  However, the plant oil which does spread the rash may remain on unwashed skin, clothing and animal fur (the animal is not affected) and can transmit the rash to other areas and other people.

TREATMENT:

A . Small areas: Aveeno Anti-itch Lotion will temporarily relieve itching.  Caladryl, which is calamine lotion and an antihistamine, or Benadryl cream not recommended since it alone, can cause a sensitization rash.

B .  Raw red oozing areas: Apply soaks of a solution consisting of 2 teaspoons salt in 1 quart of water which has been allowed to cool.  Apply for ½ to 1 hour every 4-6 hours.  A wash cloth or cotton material is wrung out and placed on the affected area and continued until oozing no longer occurs.  Bathing with colloidial oatmeal (Aveeno) is also comforting.

C . Antihistamines: To reduce itching, give_____teaspoon/capsule/tablet of___________

Every _____hours for _____days.  Antihistamines may cause drowsiness.

D . Cortisone__________cream/ointment applied sparingly 4-6 times daily.  Whenever an ointment or cream is used, apply the first several applications to a small area to be sure the skin can tolerate it.

As a last resort, for very severe case, cortisone-type drugs are given by mouth.  While they cause rapid improvement in the rash, they can upset the body’s metabolism.  Give _____teaspoon/tablet of __________each _____hours for _____days.

E . Sun, sweating, swimming and strenuous activities should be avoided, since they will make the rash and itching worse.  Do not use Band-Aids.

PREVENTION:

1 . Destroying the plant whenever possible by removal or commercial defoliation.  Do not burn the plants as this can cause severe reactions.

2 . Recognize and avoid plants as well as animals in contact with these plants.

3 . Wash the skin with detergent soap and water within minutes of exposure.

4 . Contaminated clothing stored at room temperature can produce the dermatitis for at least 1 week.  Therefore all such clothing should be thoroughly washed at high temperatures.  Rinsing in Clorox for 15 minutes should help to remove the oil resin.  Shoes, sandals, sneakers should also be cleaned.

5 . Animal fur that may contain the sap should be removed by washing with soap and water.

6 . The rash can usually not be prevented by washing contaminated skin.  Cleaning with soap and water may, however reduce the chance of spread by removing the plant oil.