Poison ivy

My 8-yr old son came in contact with poison ivy on 9/15/01.  He had gone to the edge of the woods behind his school to get a ball.  He placed the ball under his arm and broke out under his arm and leg 2 days later.  We have had 4 visits to the pediatrician and has been on Prednisone, a strong steroid ointment along with antihistamines.  At first he showed progress but has raised places throughout his body with some areas resembling poison ivy and others that don't.  The dr stepped up the Prednisone yesterday and states if not better by tomorrow, will refer to a dermatologist.  All 4 drs appear to be unsure as to what is going on.  I have washed everything and he was even been treated for scabies without improvement.  We are very concerned as to what else could be going on.  Any suggestions?

[Alan Rockoff, MD]

I doubt that anything is going on other than delayed disappearance of posion ivy.  If exposure was extensive (and it would have come from the bushes, not the ball, then ongoing appearance of new lesions can go on for days to weeks.  These new lesions are due to continuing immune activity, not spread from posion ivy resin on the skin, which has surely been washed off many times over by now.  It is possible that the early doses of prednisone were too low to suppress immune activity.  It is also at least conceivable, though unlikely, that the original diagnosis was something else.  I therefore think that dermatologic referral makes sense.  It certainly doesn't sound like scabies.  So go ahead and get another opinion, but I am confident that at the end of the day, your son will be fine.  He'll just need to be carefl in or near the woods.

Best.

Dr. Rockoff