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Effectiveness of various barrier preparations in preventing and/or ameliorating experimentally produced Toxicodendron dermatitis.

BACKGROUND: Despite extensive research on hyposensitization and prior application of topical barrier preparations, efforts to prevent Toxicodendron dermatitis have been only minimally successful. OBJECTIVE: Seven different barrier creams were evaluated for topical protection against experimentally produced Toxicodendron dermatitis in a randomized, double-blind study. METHODS: Twenty patients had the seven barrier creams randomly applied to eight test sites (one untreated area as control) on each forearm before application of the Toxicodendron extract. Development of Toxicodendron dermatitis was followed for 8 days, with measurements of erythema, induration, vesiculation, and global severity taken at each site on days 1, 2, 3, 4, and 7 after Toxicodendron application. RESULTS: The barrier creams Stokogard, Hollister Moisture Barrier, and Hydropel significantly reduced the erythema, induration, and global severity of Toxicodendron dermatitis and did not differ from each other. The percent reductions in global dermatitis severity per day of assessment for the seven barriers in order of effectiveness were as follows: Stokogard, 59%; Hollister Moisture Barrier, 52%; Hydropel, 48%; Ivy Shield, 22%; Shield Skin, 13%; Dermofilm, 13%; and Uniderm, -9%. During the 8-day period, a significantly greater number of test sites pretreated with Stokogard, Hollister Moisture Barrier, and Hydropel were free of dermatitis compared with control sites and sites treated with the other four barriers. CONCLUSION: The results indicate that Stokogard, Hollister Moisture Barrier, and Hydropel are effective in the prevention of Toxicodendron dermatitis.

Administration, Cutaneous↗

Recognizing the Toxicodendrons (poison ivy, poison oak, and poison sumac).

Poison ivy, poison oak, and poison sumac are now classified in the genus Toxicodendron which is readily distinguished from Rhus. In the United States, there are two species of poison oak, Toxicodendron diversilobum (western poison oak) and Toxicodendron toxicarium (eastern poison oak). There are also two species of poison ivy, Toxicodendron rydbergii, a nonclimbing subshrub, and Toxicodendron radicans, which may be either a shrub or a climbing vine. There are nine subspecies of T. radicans, six of which are found in the United States. One species of poison sumac, Toxicodendron vernix, occurs in the United States. Distinguishing features of these plants and characteristics that separate Toxicodendron from Rhus are outlined in the text and illustrated in color plates.

Plants, Toxic↗

Toxicodendron dermatitis: poison ivy, oak, and sumac.

Allergic contact dermatitis caused by the Toxicodendron (formerly Rhus) species-poison ivy, poison oak, and poison sumac-affects millions of North Americans every year. In certain outdoor occupations, for example, agriculture and forestry, as well as among many outdoor enthusiasts, Toxicodendron dermatitis presents a significant hazard. This review considers the epidemiology, identification, immunochemistry, pathophysiology, clinical features, treatment, and prevention of this common dermatologic problem. Recent research in prevention is emphasized, and resources to help in the identification of plants are provided in the bibliography. The literature was searched using a MEDLINE query for "Toxicodendron dermatitis", and the identified article bibliographies were searched as well.

Dermatitis, Toxicodendron↗

Sodium lauryl sulfate irritant patch tests. II. Variations of test responses among subjects and comparison to variations of allergic responses elicited by Toxicodendron extract.

Inflammation was induced on the forearms of volunteers by twenty-four closed patch tests to either the irritant 10% sodium lauryl sulfate (SLS) or Toxicodendron extract. Each chemical was tested at eight sites on the ventral forearms of each volunteer in order to assess the variability of response among test sites in individual subjects. Inflammation was assessed about 10 minutes after patch tests were removed. The degree of inflammation elicited by both Toxicodendron and SLS was variable among subjects, but variation among individual test sites was much more marked in subjects tested with SLS (p less than 0.002). The marked variability of responses to irritation that occur in any single subject may explain why irritant patch test responses do not reliably identify the irritation-prone individual.

Adolescent↗

Biomass and toxicity responses of poison ivy (Toxicodendron radicans) to elevated atmospheric CO2.

Contact with poison ivy (Toxicodendron radicans) is one of the most widely reported ailments at poison centers in the United States, and this plant has been introduced throughout the world, where it occurs with other allergenic members of the cashew family (Anacardiaceae). Approximately 80% of humans develop dermatitis upon exposure to the carbon-based active compound, urushiol. It is not known how poison ivy might respond to increasing concentrations of atmospheric carbon dioxide (CO(2)), but previous work done in controlled growth chambers shows that other vines exhibit large growth enhancement from elevated CO(2). Rising CO(2) is potentially responsible for the increased vine abundance that is inhibiting forest regeneration and increasing tree mortality around the world. In this 6-year study at the Duke University Free-Air CO(2) Enrichment experiment, we show that elevated atmospheric CO(2) in an intact forest ecosystem increases photosynthesis, water use efficiency, growth, and population biomass of poison ivy. The CO(2) growth stimulation exceeds that of most other woody species. Furthermore, high-CO(2) plants produce a more allergenic form of urushiol. Our results indicate that Toxicodendron taxa will become more abundant and more "toxic" in the future, potentially affecting global forest dynamics and human health.

Biomass↗

Toxicodendron dermatitis in the UK.

BACKGROUND: We present two cases of Toxicodendron dermatitis, one acquired in the United States but presenting in the United Kingdom (UK), the other a recurrent dermatitis following importation of the plant to the UK. Poison ivy, poison oak and poison sumac are native to North America and belong to the genus Toxicodendron. This group of plants is of interest to the dermatologist because they contain a mixture of potent sensitisers which cause a severe allergic contact dermatitis. CONCLUSIONS: The dermatitis can present to the dermatologist in Europe after an individual has been in contact with the plant whilst visiting an endemic area. The plants have the potential to grow in Europe and it is therefore possible for an individual to be sensitised and subsequently to develop the rash without leaving the continent.

Adult↗

New GLC analysis of urushiol congeners in different plant parts of poison ivy, Toxicodendron radicans.

Methods are presented for the direct GLC analysis of the catechol C15 alkenyl side-chain congeners contained in the urushiol fraction of poison ivy (Toxicodendron radicans) and the C17 homologs of poison oak (Toxicodendron diversilobum). A number of liquid phases were investigated and demonstrated varying degrees of separation. The methods developed were applied to the analysis of the urushiol fractions obtained from different plant parts of poison ivy. The effects of extraction before and after drying demonstrated tht a larger percentage of urushiol was obtained when the fresh plant material was extracted with ethanol.

Catechols↗

Clinical and immunologic features of systemic contact dermatitis from ingestion of Rhus (Toxicodendron).

Oral or parenteral exposure to certain contact allergens may elicit an eczematous skin reaction in sensitized individuals. This phenomenon has been called systemic contact dermatitis (SCD) and is relatively rare when compared with classical contact dermatitis. We reviewed and analysed the clinical and immunologic features of 42 patients with SCD caused by ingestion of Rhus (Toxicodendron), 24 males and 18 females, average age 44 years (range 24-72). Several of such patients (33%) had a known history of allergy to lacquer. The patients developed skin lesions such as generalized maculopapular eruptions (50%), erythroderma (29%), vesiculobullous lesions (14%) and erythema multiform (EM)-like lesions (7%). Many patients (57%) developed leucocytosis with neutrophilia (74%). In some patients (5%), abnormalities of liver function developed. We also analysed lymphocyte subsets in the peripheral blood of 12 patients. The lymphocyte subsets studied were T cells (CD3), B cells (CD19), natural killer (NK) cells (CD3-CD16+/CD56+), helper/inducer cells (CD4), cytotoxic/suppressor cells (CD8) and helper/suppressor ratio (CD4/CD8). The lymphocyte subsets of all 12 patients studied were within the normal range. Moreover, there were no differences between patients with a history of allergy to lacquer and those without a history of allergy to lacquer. Therefore, rather than an immunologic response, the skin eruption seems to be caused by a toxic reaction because of Rhus.

Administration, Oral↗

Allergic contact dermatitis to Toxicodendron succedaneum (rhus tree): an autumn epidemic.

AIMS: To document all cases of allergic contact dermatitis (phytodermatitis) due to contact with Toxicodendron succedaneum (rhus tree) presenting to a dermatology clinic during 1993. METHOD: Case-note review of all cases of phytodermatitis attributed to exposure to rhus tree seen during 1993 in a dermatology clinic. RESULTS: Twenty cases of phytodermatitis to T succedaneum were reviewed. Eight patients were females and 12 males with a bimodal age distribution (ten children under age of 15 yr, five adults between 35-45 yr of age). Younger patients presented with facial dermatitis reflecting facial contact whilst playing under rhus trees. Older patients presented largely with a dermatitis affecting the upper limbs reflecting contact whilst gardening (usually pruning). Fifteen out of twenty presented during the months of March through May (ie. autumn), with the remainder presenting in summer (Dec-Feb). The majority of patients required systemic steroids to settle the intense dermatitis. CONCLUSIONS: Phytodermatitis to T succedaneum is not uncommon in New Zealand, particularly during the autumn months. The clinical presentation varies according to the patient's activity.

Adolescent↗

Toxicodendron antigen patch test. Degrees of inflammation observed after various time intervals.

Allergic contact dermatitis was elicited with Toxicodendron antigen and the patch test site examined at various time intervals up to one week. The degree of inflammation was rather constant during the observation period. The mean erythema score at 168 hours was not significantly different from the score at 24 hours. These data support the use of a delayed (96-hour) patch test reading as a guide to discriminating between allergic and irritant patch test reactions.

Adult↗

[Contact allergy caused by poison ivy (Toxicodendron spp].

Within 3 days two female patients presented with an eruption featuring erythema, edema, vesicles and bullae. We suspected poison ivy allergy which was subsequently proven by history and positive patch tests. In Germany the risk of specific hypersensitivity to Toxicodendron species is low, since the distribution of such plants is confined to botanical gardens. Other species belonging to the family of Anacardiaceae contain urushiols as well (e.g., mango, cashew) and may cause allergic contact dermatitis.

Adult↗

Extract of Toxicodendron quercifolium caused genotoxicity and antigenotoxicity in bone marrow cells of CD1 mice.

As has been shown in numerous studies, naturally occurring compounds can have protective effects towards mutagens and carcinogens. In the present study, the genotoxic/antigenotoxic effect of Toxicodendron quercifolium (poison ivy) extract, which has been identified as antigenotoxic in human HepG2 cells in former studies, was examined in the in vivo micronucleus assay using polychromatic erythrocytes (PCE) of bone marrow of CD1-mice. For this, D0 (1:10), D0 (1:25), D0 (1:50), D1 (1:50), D2 (1:50), and D4 (1:50) dilutions of ethanolic plant extract prepared on the basis of the "Hömoopathisches Arzneimittelbuch (HAB 2000)" were administered orally to CD1 mice over a period of two days. A significant increase (p < 0.05) in micronucleus frequencies was found after administration of D0 (1:10), the highest tolerated dose. Additionally, antigenotoxic effects of T. quercifolium towards benzo(a)pyrene-induced micronucleus formation were studied. For that, four dilutions of the plant extract [D0, D2, D4, D6, each 1:50] were administered orally to CD1 mice for five days prior to the administration of benzo(a)pyrene (250 mg/kg b.w.) for another two days. It was found that the administration of the dilutions D0 (1:50) and D2 (1:50) of T. quercifolium extract significantly inhibited benzo(a)pyrene-induced micronucleus formation (p < 0.0001). The results of this study indicated that T. quercifolium extract has the character of a so-called "Janus"-genotoxin: High doses led to a weak but significant increase of micronucleus frequencies whereas low doses showed chemopreventive effects towards benzo(a)pyrene-induced DNA damage. The constituents of T. quercifolium responsible for the genotoxic and antigenotoxic effects may be flavonoids, which are known to have prooxidative and scavenging effects and identified by HPLC-MS/MS.

Animals↗

Rhus (Toxicodendron) dermatitis.

This article reviews the current fund of knowledge on poison ivy, poison oak, and poison sumac dermatitis. It is intended as a global summary to provide the primary care provider with the required information and sources for more esoteric academic pursuits. Toxicodendron characteristics, morphology, and biology are reviewed. The overall medical impact is delineated as well as the clinical manifestations, pathophysiology, prevention, and treatment. Historical perspectives are mentioned throughout, as are future trends in research.

Dermatitis, Toxicodendron↗

Toxicodendron radicans dermatitis with black lacquer deposit on the skin.

Four patients with clinical Toxicodendron dermatitis (poison ivy) presented with dramatic black lacquer-like deposits on several lesions. This black deposit was also observed at sites of injury on poison ivy plants and was reproduced on volunteers by the application of plant sap on the skin. Histologically, the observed material was identified in the stratum corneum. This little-recognized phenomenon has been mentioned in past dermatologic literature.

Adolescent↗

Treatment of toxicodendron dermatitis (poison ivy and poison oak).

Toxicodendron dermatitis results from a reaction to an oil soluble oleoresin that is present in many parts of the poison ivy and poison oak plants. Prophylactic measures include avoidance, protective clothing, barrier creams and hyposensitization. Treatments include washing the area immediately with a solvent suitable for lipids and the use of anti-inflammatory agents, especially corticosteroids.

Bentonite↗