Emergency: Treating poison ivy, oak, and sumac.

摘要

Still no magic bullet-but a range of options, old and new. Gary Bullis is a 49-year-old electric utility worker who presents to the ED complaining of a rash and severe itching for the last six days. (This case is a composite based on my experience.) He says the rash began to appear about 24 hours after a day of work cutting tree branches away from power lines. According to Mr. Bullis, poison ivy vines were intermingled with many of the branches. Hoping to remove any "poison ivy sap," he showered when he returned home from work. His forearms and the backs of his hands are now covered with a red rash and have 1+ to 2+ edema. He has a 2 in. x 3 in. area of erythema on his neck and reports that his genitals are also affected. There are multiple 1-cm fluid-filled vesicles on all of his affected areas. He reports having applied 1 % hydrocortisone cream to these areas three times a day since the rash appeared, but without much relief.