Allergic Contact Dermatitis

Question 1

Chemical that causes the rash from poison ivy, oak, sumac, and mangoes

Answer 1

Urushiol

Question 2

Causes of ACD

Answer 2

Latex allergy, contact with toxicodendron plants, metals, topical ABX, topical steroids, topical anesthetics, propylene glycol, certain fragrances

Question 3

Clinical manifestations of ACD

Answer 3

Erythematous, indurated, scaly plaques, vesiculation and bullae in severe cases

Secondary: excoriation, impetiginization

Question 4

Pharmacologic therapy for ACD: topical corticosteroids

Answer 4

FIRST-LINE TREATMENT!
High potency on thick skin
Medium potency on face or flexural areas for no more than 2 weeks

Question 5

Pharmacologic therapy for ACD: topical calcineurin inhibitors

Answer 5

For chronic or localized ACD on face

Slower onset of action

Question 6

Pharmacologic therapy for ACD: systemic corticosteroids

Answer 6

For patients with ACD >20% of BSA or for acute ACD of face, hands, feet, or genitalia

Question 7

Nonpharmacologic therapies for ACD

Answer 7

Avoid offending agent, drying agents for weeping vesicles, oatmeal baths, calamine lotion

Question 8

Patient education with a latex allergy

Answer 8

Avoid products with latex in them, wear a medical bracelet that says that they have a latex allergy

Question 9

Patient education for toxicodendron dermatitis

Answer 9

Wear protective clothing, wash clothes and pets after exposure, barrier creams like bentoquatam are controversial