Term
| Pathophysiology of Poison Ivy/Oak/Dermatitis |
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Definition
| allergenic substance secreted by plants called URUSHIOL --> light, colorless oil released from damaged plants, turns inky black & hardens upon air exposure, remains active for long periods of time; inactivated when exposed to wet environment; Allergic response occurs in 2 steps: 1) sensitization ("induction phase") - initial exposure, no dermal symptoms; 2) dermatitis occurs 2-10 days later in very sensitive pts --> re-exposure induces Type IV delayed hypersensitivity Rxn, allergic rxn develops within 2-48 hrs |
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Term
| Clinical Presentation of Poison Ivy |
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Definition
| intense pruritus & erythema followed by formation of vesicles that open easily --> ooze & weep for several days, affected area develops crusts & begins to dry; occurs on exposed or unprotected skin surfaces; spreads to protected areas with contaminated hands/fingernails (scratching) --> appears in linear pattern on affected areas, more diffuse when spread by indirect contact; resolution occurs in 10-21 days |
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Term
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Definition
| localized patches of pruritus & erythema, with linear streaking of vesicles & papules, swelling of eyelids & face |
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Term
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Definition
| appearance of bullae and edematous swelling of various body parts in addition to symptoms of mild dermatitis |
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Term
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Definition
| extensive involvement, edema of extremities & face, extreme pruritus, itching, severe vesicle/bullae formation, eyelids swollen closed; inability to perform daily activities; need for immediate medical referral |
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Term
| Complications of Poison Ivy |
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Definition
| 2ndary bacterial infections (Staph. aureus, Group A Strep, E.coli); eosinophilia, eryhtema multiforme, ARDS, renal failure |
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Term
| Nonpharm Treatment of Poison Ivy |
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Definition
| remove contaminated clothing; cleanse suspected area (Tecnu Outdoor Skin Cleanser, Dial Ultra diswashing soap, Goop grease remover), take cold or tepid showers, avoid vigorous scrubbing of affected areas, clean & trim fingernails, launder contaminated clothes separately, use vinyl gloves & wash equipment or objects that may have been exposed |
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Term
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Definition
| topical symptomatic therapy: calamine lotion, sodium bicarb (baking soda), aluminum acetate, colloidal oatmeal bath, AVOID USE OF TOPICAL ANTIHISTAMINES & ANESTHETICS, topical corticosteroids (hydrocortisone), oral corticosteroids (prednisone) |
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Term
| calamine lotion (Caladryl) |
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Definition
| relieves itching; shake lotions; apply topically every 4 hrs PRN; DO NOT apply to open lesions; leaves light pink-colored film |
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Term
| sodium bicarbonate (baking soda) |
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Definition
| relieves itching & irritation; Uses: paste, warm bath, cool compress; Avoid use near EYES |
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Term
| aluminum acetate (Burow's solution) |
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Definition
| astringent - reduces weeping/oozing, removes crusts, & soothes skin; cool compress applied for 30 min at least 4 times daily or more; continue for 5-7 days while vesicles/lesions ooze; may dry, tighten, or contract skin |
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Term
| colloidal oatmeal bath (Aveeno Bath Treatment Soothing Formula Powder) |
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Definition
| cleanses skin debris, soothes lesions, & reduces itching; provides skin hydration; use in warm bath; soak for 15-20 min at least 2 times per day; pat dry skin to leave a thin film |
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Term
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Definition
| indicated for severe cases of poison ivy &/or if symptoms persist despite use of nonprescription products; Usual starting dose: 1 mg/kg/day; Dose is tapered down over 2-3 wks; Recommended duration of therapy: 12-21 days |
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Term
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Definition
| hold moisture within skin & act as reservoir for active ingredient; more effective if applied before vesicles open & begin oozing; DO NOT apply to open lesions |
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Term
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Definition
| allow vesicle fluid to flow freely & does not trap bacteria; quickly absorbed into skin; |
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Term
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Definition
| easy application; rapid absorption into skin; may contain alcohol or solvents which can cause irritation or burning if applied to open lesions |
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Term
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Definition
| easiest form of drug application; even distribution to large areas; more expensive; may contain propellants that cause inflammation |
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Term
| Patient Counseling for Poison Ivy |
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Definition
| Seek medical attention if: pt <2 yrs old, extreme itching with severe vesicles, widespread rash or edema, rash affects eyes, face, OTCs do not relieve, if it has not subsided in 7 days, if it impairs daily activities; Preventative Measures: education & avoidance (additional protective clothing), barrier product (Ivy Block Lotion [bentoquatam]) |
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