Special Forms of Contact Dermatitis

Filed under: 3.5 - Contact Dermatitis

Plant Dermatitis

In some parts of the country, derma­titis from weeds,⁷ particularly rag­weed, is common in adults; it is not common in children. The dermatitis is caused by contact with the oil con­tained in the leaves, stems, and pollen. Patch tests are positive. Eczema from pollen is common in children, but this is of the atopic variety, and is caused by inhalation of the pollen. Patch tests are negative, scratch or intracutaneous tests are positive, with the protein fraction of the pollen. Ordi­nary “poison ivy” is, of course, common in children almost everywhere.

Treatment of Poison Ivy

1. Prophylactic.-There is much in the literature about this; some think that it is worthless, some that it is of great value. I have not had enough experience with prophylactic treat­ment for poison ivy to form any worth-while conclusions. From what little I have seen, from what I have read, and from the information gathered by word of mouth from others who have used it more than I, it would seem that it is worth while, but not reliable. It can be done by inoculation or by iugestion. Which is the better of the two methods, I do not know.

‘Shelmire, Bedford: Contact Dermatitis From Weeds: Patch Tests With Their Oleo Resins, J. A. M. A. 113: 1085, 1939

a. Inoculation: “Ivyol”*: 0.5 c.c. is injected intramuscularly each week for four weeks before the start of the ivy season.

b. Ingestion: “Rhus Tox”t: Start in the late spring with 5 drops three times a day in half a glass of water; increase 3 drops each day up to 15 drops three times a day. Give this dose every day all summer, f

2. Local Treatment.-Poison ivy dermatitis is a self-limited disorder; it will get well by itself if you do not try to do too much to it. In its more severe forms, however, it is what I would call a ”very bad disease,” and may require a good deal of treatment.

a. Under no circumstances give any inoculation with poison ivy extract. This is likely to do more harm than good if given when ivy dermatitis is present.

b. If the dermatitis is oozy, use wet dressings of 1 to 10,000 potassium permanganate solution, or Burow’s solution, 1 tablespoonful to a glass of water.

c. If not oozy, apply the following lotion several times a day:

(Rx)      Acid carbolic     gr. xx Zinc oxide 3 ss Lime water § viii

d. After the acute stage has passed, use Lassar’s paste for a few days- then a mild salve such as zinc oxide ointment (U.S.P.) or Acid Mantle Creme.§

e. If there is much itching at night, give chloral hydrate,!] °r Nembutal or Seconal.

f. In severe cases use cortisone by mouth, 100 mg. a day to children over 6 years, 75 mg. a day to those under 6 years, until the worst is over, then gradually reduce the dose and soon discontinue it.

* Sharp & Dohme, Philadelphia.

tThe  National   Drug-  Co.,  Philadelphia. tit there   is  any  burning- or itching-  about the rectum, the dose should be reduced. §Dome   Chemicals   Inc.,   New  York. USquibb’s.

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