|
Excerpts from Dermatology Textbooks
Champion, p. 737:
Poison-oak urushiol is an intermediately
potent sensitizer. Half of Americans become sensitive to 25
micrograms, applied once under a Band Aid, in six to
thirty-five days. Increasing the dose to 50 mcg increases the
number of reactors to 80 %.
After the first reaction, response to
re-exposure occurs more rapidly. Twenty-four to forty-eight
hours is usual.
Re-exposure sufficient to provoke a
reaction boosts sensitivity. After the re-exposure, reactions
begin to traces of the allergen so small they would not have
previously incited a response.
ANACARDIACEAE, pp.
63-97 and 95 in Mitchell and Rook:
Carriage by
the fingers may extend the eventual distribution. It also
accounts for the initial involvement of sites remote from
those of greatest contact, as in lacquer dermatitis of the
face in Mah Jongg players. The thicker horny layer on the
fingers provides some protection.
However, by
the time blisters form the haptene has polymerized and become
attached to the tissues. The blister fluid is not dangerous to
touch.
The eruption evolves in crops, affecting
first the sites where the most allergen has been absorbed, and
then successively the less heavily contaminated sites. Malaise
and fever are unusual. The dermatitis commonly reaches its
full extent in 48 hours. Healing occurs within two weeks,
without scars unless secondary infection occurs.
However, if the plant is eaten there may
be vomiting and diarrhea, drowsiness, convulsions, delirium,
fever, and pupillary dilation. Nephritis, too, may complicate
poisoning, either by ingestion or after massive cutaneous
vesication. References: Rytand, DA (1948) “Fatal anuria, the
anephrotic syndrome and glomerulonephritis as sequels of the
dermatitis of poison oak” Am. J. Med. 5 548. Templeton,
HJ et al (1947) “Poison oak dermatitis: studies on
haematologic, urinary and temperature changes” J. Invest.
Derm. 8 53.
Author’s Note:
There seem to be threshold phenomena
involved, determining when and whether a rash occurs. I have
read that T8 lymphocytes have an anti-inflammatory influence;
they delay the start of reactions, and initiate healing. |