Contact Dermatitis, Intertrigo, & Poison Ivy

Question 1

What are the two main types of contact dermatitis?

Answer 1

Irritant (contact with chemicals and caustic materials, amount of exposure is important)

Allergic (amount of exposure is not important, ex. nickel allergy and poison ivy)

Question 2

Does BP usually cause allergic or irritant dermatitis?

Answer 2

BP usually causes irritant dermatitis. Allergies to BP are rare

It is almost impossible to determine the type from a given case

Slowing down ramp up or using dry skin lotion is a valid change

Question 3

Describe the onset of irritant dermatitis?

Answer 3

Acute (few days): formation of blisters. If exposure is short, wash off irritant to prevent blistering

sub-acute: healing blisters (1 week)

Chronic exposure (weeks to months): the body will add more keratin to protect the skin from irritation

Question 4

Describe the treatment for the different types of irritant dermatitis?

Answer 4

Acute: cool wet dressings for 20 minutes QID (do not need bandaging)

Sub-acute (healing blisters): discontinue wet dressings, steroid lotion or cream

Chronic: warm water soaks soften up tissue before agent is applied (dry skin creams or steroid cream/ointment)

Question 5

Do warm water soaks cause dryness?

Answer 5

Yes, but the key to solve this issue is to apply an eczema-grade dry skin lotion. A steroid cream or ointment are also valid options

Question 6

What is intertrigo?

Answer 6

Inflammation caused by skin-to-skin friction, most often in warm, moist areas of the body

Can be found anywhere on the body
ex. abdominal skin folds, under breasts, under the arms

Question 7

Is jock itch a type of intertrigo?

Answer 7

Yes

Question 8

What do poison ivy reactions look like?

Answer 8

Poison ivy is caused by an urushiol resin allergy

People get a rash and blistering in 12-48 hours (often seen in streaks, caused by spread of urushiol resin)

It is an allergic reaction (delayed response), so the first contact with poison ivy causes sensitization. The next contact with poison ivy causes blisters

Question 9

How to treat poison ivy?

Answer 9

Wash off immediately (if you are aware of contact)

broken blister fluid will not spread it (urushiol resin will)

Try cool compress, calamine, or topical steroid (mid potency)

mild reactions subside in 7-10 days

Question 10

Is Benadryl useful in poison ivy treatment?

Answer 10

There isn’t consensus in the medical community

But we would reccomend second generation antihistamines over Benadryl, but they definitely are not the drug of choice