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What are the (4) Non-Pharmacologic treatments of contact dermatitis?
- Avoid allergen- drug, clothing, common sense
- Remove Urushiol- w/in first 10min
- Trim fingernails
- Tepid showers
What are the (6) pharmacologic therapies for contact dermatitis?
- Topical anesthetics
- Topical Wash
What are the (3) primary topical anesthetics? And why are they used?
- (to reduce itching)
What is the mechanism of topical anesthetics?
prevents impulses being carried to sensory neurons which sense pain or itching
What is the dosing of topical anesthetics?
apply up to 3-4 times daily
Which corticosteroid is most commonly used with contact dermatitis?
What is the mechanism of hydrocortisone in treating contact dermatitis?
reduce pruritis and inflammation
What is the dosing of topical corticosteroids?
apply up to 3-4 times a day
When are systemic steroids used to treat contact derm and what's the dose?
- for severe cases
- 1mg/kg/day prednisone eq. tapered 12-21 days
___mg of methylpred = ___mg of prednisone
What counterirrtants are used to treat contact derm?
What is the mechanism of counterirritants?
- depress the skins sensory receptors
- local antipruritic and mild anesthetic properties
What is the dosing of counterirritants?
apply up to 3-4 times a day no longer than a week
What are the adverse effects of counterirritants?
local burning/irritation seen mostly on open lesions
What are the (6) Astringents?
- Aluminum acetate
- Zinc oxide
- Zinc acetate
- Sodium bicarbonate
- Witch hazel
What is the mechanism of astringents is treating contact derm?
- promotes drying of wet dermatitis by contracting of the skin
- reduce inflammation and promote healing
What are the adverse effects of astringents?
- drying of skin
- cosmetically unappealing
What are the (7) most commonlt used antihistamines used in contact derm?
What is the mechanism of antihistamines?
- Block H1 receptors
- reduce inflammation and itching
What is the dosing of:
- Apply 3-4 times daily
- 25-50mg Q6-8hrs
- 25mg Q6-8hrs
- (Do NOT use more than 7 days)
What are the adverse effects of topical and systemic antihistamines?
- Topically: may cause sensitization which can lead to worse respone
- Systemic: anticholinergic effects, sedation
When should you avoid using 1st generation antihistamines?
- Chronic Bronchitis
What is the topical wash used to treat contact derm?
What is the mechanism of Zanfel?
Removes urushiol from binding sites in the skin
What is the dosing of Zanfel?
- Apply once daily as soon as possible after exposure
- (rarely need 2nd dose)
What are other agents used to treat contact derm?
- Bentoquatam (Ivy-block)
What are the characteristics of Ivy-Block?
- Approved barrier to urushiol
- Apply prior to exposure and reapply Q4hrs
- Generally well tolerated
What are the characteristics of Oatmeal baths?
- Provides soothing sensation
- Bathe 15-30mins BID
- Makes bath-tub slippery