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Toxicodendron: A painful summer institution

Toxicodendron: A painful summer institution. A Latin Refresher:. Toxicodendron means Poisonous Tree Toxicodendron radicans is Poison Ivy Toxicodendron toxicarium is Poison Oak Toxicodendron vernix is Poison Sumac. Leaves are primarily trifolate.

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Toxicodendron: A painful summer institution

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  1. Toxicodendron: A painful summer institution

  2. A Latin Refresher: • Toxicodendron means Poisonous Tree • Toxicodendron radicans is Poison Ivy • Toxicodendron toxicarium is Poison Oak • Toxicodendron vernix is Poison Sumac

  3. Leaves are primarily trifolate

  4. Urushiol is the allergenic component. It is a kind of oil found in the leaves, stems, and roots.

  5. It is found in other foodstuffs:

  6. Urushiol penetrates the epidermis and binds to Langerhans cells. In sensitized patients, previously stimulated helper T cells recognize the urushiol and initiate an immune response.

  7. Time Course • Symptoms develop in 4 to 96 hours. • Symptoms can peak up to 2 weeks after exposure. • The fluid in the blisters is NOT antigenic. The rash doesn’t spread. Continued infection is due to re-exposure. • Allergic responsiveness wanes with age, particularly in those with milder reactions.

  8. More information about urushiol: • It binds to cell membranes. After an hour or so, it won’t wash off. • It is stable at high temperatures. So, burning poison ivy or poison oak disperses through the air with it’s allergenic potential intact. It can cause inflammation and irritation of respiratory tissues. • It is stable in general, and can remain on fomites for a long time. Some say up to 5 years! • It can waft on a summer breeze and cause a reaction in the very very allergic. • Some native American tribes use it to remove warts. • Only homo sapiens react to it.

  9. Looks like:

  10. Not…

  11. Complications • Edema, especially when the face or genitals are affected. • Respiratory difficulties. • Bacterial super-infection, primarily with gram positive organisms.

  12. Treatment • Calamine lotion and oatmeal baths. • Sedating anti-histamines. • High potency topical corticosteroids. (But not on mucous membranes or in skin folds.) • Systemic glucocorticoids if: face or genitals are affected; more than 10% of the body is involved; reaction is severe. Start with 1 mg/kg of prednisone, give it for a week, and then taper over the next two weeks. • NB: Avoid topical benadryl, which causes a reaction all it’s own.

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