Poison ivy on your face...

[krodUT]

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I just thought I'd toss this question to you derm folks. Yesterday when I took Step 2 CK I had a question about how to treat an adolescent male who had poison ivy on his arm and face. There were no options for oral or injectable steroids. I was between topical diphenhydramine and topical 2% hydrocortisone. I remember hearing on my pedi outpatient rotation to use caution when using steroids on the face because they can lead to scarring, skin thinning, etc.

I can't seem to find this answer online and am still curious. What do you all think? Much appreciated and good luck on the application process.

 

[IzzyMD09]

tough question, I dont know

 

[IzzyMD09]

I still think a 2% low potency steroid (dont know if its a lotion cream ointment...not sure it matters) would stop the inflammation and hence the pain and itch, I am not sure what a topical anti-histamine would do if it would do anything at all long term aside from stop itch

My train of thought is that the histamine release into the blood stream causing the manifestation of the hypersensitivity reaction is due to the inflammatory cells in the skin (Mast cells and what not), so maybe a more systemic anti-histamine would have been better,

what do I know though?

 

[Dral]

I hate to be one of those stickler for the rules types, but anyway...as far as I understand it, it's kinda not good to discuss portions of the USMLE exams...especially on public forums.

 

[MOHS_01]

BS question with no good answer. Would have to go with 2% HC, but that is like pissing in the ocean.

Oral pred is the way to go, BTW.

 

[deltamed]

I suspect the right answer was one you didn't consider.

Was it stated "he has poison ivy" or was it maybe something else?

2.5% hydrocortisone would be pretty useless. Probably not written by a dermatologist if that's what they wanted you to answer.

 

[N-Surge]

i hate to be one of those stickler for the rules types, but anyway...as far as i understand it, it's kinda not good to discuss portions of the usmle exams...especially on public forums.

qft