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Poison ivy, oak, sumac dermatitis in Infant/Neonate
See also in: External and Internal Eye
Other Resources UpToDate PubMed

Poison ivy, oak, sumac dermatitis in Infant/Neonate

See also in: External and Internal Eye
Contributors: David O'Connell MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Poison ivy, poison oak, and poison sumac are the common names for Toxicodendron dermatitis (formerly Rhus dermatitis). This is a contact dermatitis resulting from a type IV hypersensitivity reaction in sensitized individuals to the oleoresin urushiol. Urushiol is found in most parts of the plants from this genus, which is a member of the Anacardiaceae family. The Toxicodendron genus is pervasive throughout the continental United States, southern Canada, and Mexico and is mostly found below 5000 feet of altitude. It can also be found in Asia, Africa, Australia, and New Zealand. It is estimated that up to 75% of the North American population is sensitized and the condition has no predilection based on age, sex, race / ethnicity, or skin type. Occupational and recreational exposures are prevalent.

These species show regional variations in the nature of the plant including growth pattern, leaf characteristics, and flowering.

After exposure to urushiol, the rash begins to appear within 1-2 days in previously sensitized individuals; in the newly sensitized, it may be delayed 2-3 weeks. As the resin is very stable, occult contact may occur from contaminated clothing, gear, or vegetation, even after months have elapsed. In this age group the most common mode of contact is secondary from family members, caregivers, or pets.

Codes

ICD10CM:
L23.7 – Allergic contact dermatitis due to plants, except food

SNOMEDCT:
200823002 – Allergic dermatitis due to poison ivy

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Black dot poison ivy:
  • Melanocytic lesions, including melanoma

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Last Reviewed:03/29/2023
Last Updated:04/06/2023
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Patient Information for Poison ivy, oak, sumac dermatitis in Infant/Neonate
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Contributors: Medical staff writer

Overview

Poison ivy, poison oak, and poison sumac rashes (dermatitides) are all an allergic reaction to the oil found on the leaves and in the stems and roots of poison ivy, poison oak, and poison sumac plants (of the Rhus genus). The allergy starts after repeated exposure to the plant and may occur at any age. People usually develop an itchy rash of raised bumps (papules) and blisters in the affected areas.
  • Itching can be intense, and scratching may break the skin, resulting in bacterial infection.
  • Scratching does not spread lesions. Rather, the lesions with the most exposure appear first, and then, as the allergic reaction (immune response) increases, lesions with less exposure begin to appear.
  • Skin lesions usually begin to appear 48 hours after exposure.

Who’s At Risk

Poison ivy, poison oak, and poison sumac may affect people of all ages.

Signs & Symptoms

  • Poison ivy, poison oak, and poison sumac can occur anywhere on the body where the exposure to the plants has occurred. The arms, legs, face, and neck are commonly affected. Red and brown-red sheets of skin (plaques) and blisters appear in straight lines, and they may form a crust on top.
  • In one type of reaction ("black dot variant"), the oil from the plant leaves a black dot on the skin.
  • If the face has been exposed, extreme swelling of the face (facial edema) may develop.

Self-Care Guidelines

  • After known plant exposure, use soap and warm water to wash all potentially exposed areas within 20 minutes of exposure, to remove the plant oil. Once the oil has been washed off, there is no risk of spreading the condition to other parts of the body.
  • Be sure to wash clothes, gloves, and shoes as well.
  • Try soothing oatmeal baths (Aveeno powder) and apply calamine lotion to help relieve symptoms.
  • Wear protective clothing to avoid future reactions.
  • Try over-the-counter 1% hydrocortisone cream for mild outbreaks.
  • Try oral antihistamines (chlorpheniramine or diphenhydramine) to help relieve the itch, but these may cause drowsiness.
  • DO NOT USE topical anesthetics containing benzocaine or diphenhydramine, as people easily become allergic to these products.

When to Seek Medical Care

See your child's doctor or a dermatologist if the rash does not improve with self-care measures or appears to be getting worse.

Treatments

Your physician may prescribe:
  • A 14-20 day course of oral prednisone if you have a severe outbreak, affecting large body areas.
  • Medium-to-high-potency topical steroids to treat the trunk and arms and legs or low-potency topical steroids to treat the face and skin-fold areas if the affected areas are more limited.
  • Oral antihistamines for itching.
  • Topical or oral antibiotics if bacterial infection may be present.

References


Bolognia, Jean L., ed. Dermatology, pp.227-229. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed, pp.1167-1168. New York: McGraw-Hill, 2003.
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Poison ivy, oak, sumac dermatitis in Infant/Neonate
See also in: External and Internal Eye
A medical illustration showing key findings of Poison ivy, oak, sumac dermatitis : Erythema, Eyelids, Linear configuration, Scattered many, Tense vesicles, Arms, Legs
Clinical image of Poison ivy, oak, sumac dermatitis - imageId=113052. Click to open in gallery.  caption: 'Vesicular, erythematous plaques, some linear, and scattered vesicles on the arm.'
Vesicular, erythematous plaques, some linear, and scattered vesicles on the arm.
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