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dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 4069
Experience:  30 years practice in general and cosmetic dermatology
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Last week, I did some yard work and was in contact with

Customer Question

Last week, I did some yard work and was in contact with various plants, including English Ivy, possibly poison ivy. (Though I wasn't aware of that at the time). The next day I noticed several bumps spread across my left hand, which I thought were bug bites. Yesterday, I started breaking out on my face around my hairline. Red bumps of varying sizes, very itchy. Today, that has spread further on my fact & is also spreading to my upper chest. I'm trying to figure out what it is. I've never had anything like this.
JA: How long have you been dealing with this? Does anything in particular seem to make the itch better or worse?
Customer: I got 2 kinds of OTC creams - both have Diphenhydramine in them & are helpful. Hot & cool air also help. I was really comfortable at home last night after applying the cream and lying on my bed in front of a fan. Am at work right now and pretty miserable, the same creams are giving far less relief and the rash is continuing to spread.
JA: Anything else in your medical history you think the doctor should know?
Customer: Nothing that I can think of
Submitted: 5 months ago.
Category: Dermatology
Expert:  Dr. Captain replied 5 months ago.

Hello, welcome to the question/answer interface.

Your Doctor: I am a Family Medicine physician, trained and board-certified in the US with active licenses and certification, and 10 years of experience in Family Medicine, Internal Medicine, Pediatrics, and Obstetrics and Gynecology. I have advanced training in Integrative Medicine & Functional Medicine, Neurology, Cardiovascular Medicine, Gastroenterology, Endocrinology, and Psychiatry. I am also well-versed in Alternative Medicine. So far, 99.5% of the Justanswer community of customers has found my answers helpful, and I currently have the honor of being the highest rated clinician on the site! I will do my best to win over your approval as well!

Excellent Reviews: For your review, here is a direct link with my current ratings:

To You: I have read your post and your query. I'm sorry for the stress this must be causing you! I can imagine you must be quite concerned, and I’m glad you’ve decided to get information from the experts, instead of randomly online. Do you happen to have a camera, that you could snap and send a picture of the rash? That would be a great deal of help in understanding what rash we're dealing with here.

Customer: replied 5 months ago.
I have attached 3. I should also say - I don't have any other symptoms like a fever. Just the rash.
Expert:  Dr. Captain replied 5 months ago.

Yes, this looks like urushiol poisoning... poison ivy.

Expert:  Dr. Captain replied 5 months ago.

You have a Contact Dermatitis, likely to Urushiol Toxin in Poison Ivy, Sumac, Oak, etc

Localized pruritic dermatitis consistent with toxin exposure (urushiol toxin)

1. Avoid ongoing exposure with any potential contacts in daily environment; consider cleansing all potentially contaminated clothing with hot water and detergent

2. Take the full course of the medication given. If you need more or have questions, please call.

  1. 3. Long-sleeve shirts and pants may help avoid further exposure and reduce excoriations from itching,
  2. 4. To control itching, consider Benadryl at night, and Zyrtec, Allegra, or Claritin during the day
  3. 5. Remember the old adage: "Leaflets three, let them be." Poison ivy and poison oak have a triple- leaf structure you can learn to recognize -- and then avoid any contact with these plants when possible.
  4. 6. Cover your skin completely when hiking, camping, or working in forests and around shrubs; wear long sleeves, long pants, gloves, socks, and boots. Occasionally taping the overlapping areas may be necessary. Remember that you can also get a rash from indirect contact from clothes, pets, or objects that have urushiol (from someone else) on them.
  5. 7. Consider these options for over- the- counter symptom relief: Cool compresses, oatmeal baths, Ice to skin, Benadryl orally or topically, Burrow's Solution, Calamine lotion, topical hydrocortisone, Tench skin cleanser, Witch Hazel, Cucumber to soothe skin, Aloe Vera gel

Reasons to Return to Care:

1. Worsening illness despite regular use of treatment options as discussed

  1. 2. Concerning NEW symptoms or surprising changes
  2. 3. Any increasing localized redness (sunburn red), swelling, discharge, foul odor, or spreading into larger (or different areas), any difficulty with breathing, new abdominal pains, or chest pains
  3. 4. Alarming changes in vomiting or stooling patterns,
  4. 5. Fevers >100.4 that do not remit with use of anti- inflammatory medications
  5. 6. Desire for emotional support or help with coping through illness
  6. 7. Desire for alternative options to treat your illness
  7. 8. Questions about the progression of your illness or treatment
  8. 9. Desire for a second opinion or alternative testing methods
  9. 10. Refills of medications that you found helpful
Expert:  Dr. Captain replied 5 months ago.

most people do need a course of oral steroids, which must be prescribed by a doctor who can perform a physical exam for you.