Poison ivy (Rhus) dermatitis.
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Among the growing and diverse groups of outdoor and environmental workers, poison ivy and poison oak continue to be the major cause of occupational contact dermatitis. This article reviews the practical and theoretic means to prevent poison ivy and poison oak dermatitis in workers occupationally exposed to these weeds.
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Rhus dermatitis, experimentally induced in humans, was used as a model for determining the efficacy of various proprietary topical steroids. One-centimeter squares of vesicular dermatitis were induced by patch application of Rhus oleoresin. The steroids were then applied without occlusion once daily for four days, with readings of the therapeutic effect taken on the fifth day. Only potent steroids provided unequivocal suppression in this severe test. The rank order of efficacy corresponded to clinical experience. Cream and ointment formulations of the same steroid at the same strength did not differ. High strength preparations were more effective than regular strengths. Relief of pruritus was an important early effect of efficaceous steroids.
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Closed patch tests were used to evaluate the ability of 156 different preparations (based on 22 different chemicals) to prevent poison ivy dermatitis. Several polyamine salts of a linoleic acid dimer were identified that were totally able to prevent the usual dermatitis in approximately 70% of subjects. The effectiveness of the preparations improved when the antigen and the protectant were washed off within eight to 12 hours, instead of remaining on the skin for 48 hours. When washed off, and depending on the protectant, concentration, and vehicle used, several of the preparations were totally able to prevent a dermatitis in a range of 56% to 100% of subjects tested. Further work with these compounds may greatly benefit the many people currently plagued by their allergy to poison ivy and poison oak.
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