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Arch Dis Child 98:1022 doi:10.1136/archdischild-2013-305122
  • Miscellanea
  • Images in paediatrics

Poison ivy dermatitis

  1. A Goenka1
  1. 1 Department of Paediatrics, Royal Bolton Hospital NHS Foundation Trust, Bolton, UK
  2. 2 Department of Paediatric Dermatology, Salford Royal NHS Foundation Trust, Bolton, UK
  1. Correspondence to Dr Anu Goenka, Department of Paediatrics, Royal Bolton Hospital, Minerva Road, Bolton BL4 0JR, UK; anugoenka{at}nhs.net
  • Accepted 26 August 2013
  • Published Online First 12 September 2013

A previously well 8-year-old girl presented with a florid inflammatory eruption affecting her face and arms. She had initially noticed a linear erythematous lesion on her left cheek. This progressed over 24 h into an itchy vesicular eruption with severe periorbital oedema. A clinical diagnosis of impetigo was made in the absence of any initial history of contact exposure. There was no improvement with antibiotics. The following day, direct questioning revealed that she had been playing in a garden known to contain poison ivy (Toxicodendron radicans, previously known as Rhus radicans). This exposure occurred in Texas, and she had returned to the UK 5 days prior to the onset of the rash. The rash improved with steroid and antihistamine treatment (figure 1).

Figure 1

Appearnce 24 h after onset of the rash.

Poison ivy is the most common cause of allergic contact dermatitis (ACD) in the USA.1 The plant is not found in the UK. Linear erythematous streaks develop soon after the skin is exposed to urushiol, which is found in the resin of poison ivy.1 ,2 Vesicles typically occur 12–48 h after exposure.1 Urushiol does not evaporate well and contains allergens (pentadecylcatechols) that can persist on contaminated clothing for years.2 Smoke from burning poison ivy can provoke ACD.2 The treatment for poison ivy dermatitis varies depending on the severity of the reaction and includes antihistamines and steroids.1 ,2

In the global village, children may present with poison ivy dermatitis in non-endemic settings due to the resilience of urushiol on contaminated objects originating from endemic areas.

Footnotes

  • Contributors CH wrote the original manuscript. TH and AG both revised the manuscript critically.

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.

References