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Case Study


Poison oak contact dermatitis

(NACH CARE-LEITLINIE)

Keywords | Summary | Correspondence | References


Keywords

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Schlüsselworte

Summary

Toxicodendron or Rhus contact dermatitis is quite common in North Americas and Asia. We report a case of an occupational bullous poison oak dermatitis in a geographer from Germany. Major allergens are the urushiols. The treatment consists of topical corticosteroids are topical calcineurin inhibitors. Rarely, systemic corticosteroids may be necessary, since erythema multiforme due to Rhus dermatitis has been observed.

Zusammenfassung


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Address of Correspondence

Prof. Dr. med. Uwe Wollina
Klinik für Dermatologie und Allergologie
Krankenhaus Dresden-Friedrichstadt
Akademisches Lehrkrankenhaus der TU Dresden
Friedrichstra.e 41
D-01067 Dresden
Wollina-uw@khdf.de

Conclusion

The treatment of Rhus dermatitis consists of topical corticosteroids or topical calcineurin inhibitors. Sun protection is recommended to reduce the risk of postinflammatory hyperpigmentation. For more severe cases a short course of systemic corticosteroids may be necessary. Oral antihistamines are useful to reduce the itch [7, 12, 13]. A better option is prevention by avoiding contact to these plants and wearing protective clothes [7].

References

1. Andersen LK, Hercogov. J, Wollina U, Davis MD. Climate change and skin disease: a review of the English-language literature. Int J Dermatol. 2012; 51(6): 656-61.
2. Schempp CM, Sch.pf E, Simon JC. Durch Pflanzen ausgel.ste toxische und allergische Dermatitis (Phytodermatitis). Hautarzt. 2002; 53(2): 93-7.
3. Swinnen I, Goossens A. An update on airborne contact dermatitis: 2007-2011. Contact Dermatitis. 2013; 68(4): 232-8.
4. Jack AR, Norris PL, Storrs FJ. Allergic contact dermatitis to plant extracts in cosmetics. Semin Cutan Med Surg. 2013; 32(3): 140-6.
5. Braslau R, Rivera F 3rd, Lilie E, Cottman M. Urushiol detection using a profluorescent nitroxide. J Org Chem. 2013;78(2): 238-45.
6. Goon AT, Goh CL. Plant dermatitis: Asian perspective. Indian J Dermatol. 2011; 56(6): 707-10.
7. Gladman AC. Toxicodendron dermatitis: poison ivy, oak, and sumac. Wilderness Environ Med. 2006;17(2): 120-8.
8. Werchniak AE, Schwarzenberger K. Poison ivy: an underreported cause of erythema multiforme. J Am Acad Dermatol. 2004; 51(5 Suppl): S159-60.
9. Walker SL, Lear JT, Beck MH. Toxicodendron dermatitis in the UK. Int J Dermatol. 2006; 45(7): 810-3.
10. Cardinali C, Francalanci S, Giomi B, Caproni M, Sertoli A, Fabbri P. Systemic contact dermatitis from herbal and homeopathic preparations used for herpes virus treatment. Acta Derm Venereol. 2004; 84(3): 223-6.
11. Oka K, Saito F, Yasuhara T, Sugimoto A. A study of cross-reactions between mango contact allergens and urushiol. Contact Dermatitis. 2004; 51(5-6): 292-6. 12. Goodall J. Oral corticosteroids for poison ivy dermatitis. CMAJ. 2002; 166(3): 300-1.
13. Wollina U, Hansel G, Koch A, Abdel-Naser MB. Topical pimecrolimus for skin disease other than atopic dermatitis. Expert Opin Pharmacother. 2006; 7(14): 1967-75.

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