Poison Ivy,oak,sumac

Question 0

What is the best treatment for mild to moderate poison ivy

Answer 0

1) corticosteroid cream: mild> triamcinolone 0.1% BID
moderate>Diprolene .05% cream(orTemovate)
2)calomine/pramoxine cream
3)Benadryl or Zyrtec H.S. if itching disturbs sleep.
**if rash involves face: lower threshold for oral corticosteroids

Question 1

What is the best treatment for severe poison ivy?For Telemedicine pt.

Answer 1

1) prednisone 0.5-1 mg/kg (maximum 60 mg) for 1 week then taper over 2nd week {if hypertensive may want to give 1 week course of methylprednisolone: (42 mg max) 8 mg tabs: 5-4.5-4-3.5-3-2.5-2-1
2) Temovate cream(don’t use on face)
3) Pramoxine/calamine cream
4) Benadryl or Zyrtec H.S. If puritis disturbs sleep
* *For a non-telemedicine patient may want to use 14-21 day taper to prevent rebound.