University of Virginia School of Medicine, Charlottesville, VA.
Department of Pediatrics, University of Virginia Health System, Charlottesville, VA.
Wilderness Environ Med. 2022 Sep;33(3):351-354. doi: 10.1016/j.wem.2022.05.002. Epub 2022 Jun 17.
This article describes the clinical presentation, differential diagnosis, and treatment of 2 unrelated cases with different presentations of black-spot Toxicodendron dermatitis. In the first case, a healthy 7-y-old male presented with a rash consisting of black dots with localized surrounding erythema on the left arm. The rash then progressed to a vesicular, pinpoint, raised rash spreading to the face, arms, and neck. In the second case, a 4-y-old male presented with non-pruritic, black, flat, non-erythematous lesions that did not progress. This patient's older sibling had been diagnosed with poison ivy 1 wk prior, and they attended the same child care where the poison ivy was thought to be acquired. In both cases, diagnosis of black-spot Toxicodendron dermatitis was made. The black spot of Toxicodendron dermatitis is caused by urushiol oxidation on exposure to air. The subject may or may not go on to develop allergic contact dermatitis after the exposure. Diagnosis of this dermatitis is made on clinical presentation, with careful consideration of history, distribution, and lesion morphology. When allergic dermatitis does develop as in the first case, systemic treatment with oral steroids is recommended. In both of these cases the black dots completely resolved in 2 to 3 wk. Dermatologic referral for dermoscopy and biopsy may be necessary if the dermatosis does not resolve as anticipated.
这篇文章描述了两例表现不同的黑斑漆树皮炎的临床特征、鉴别诊断和治疗。在第一例中，一名 7 岁健康男性的左臂出现了由黑色斑点组成的皮疹，周围有局部红斑。皮疹随后发展为水疱性、针尖状、凸起的皮疹，蔓延至面部、手臂和颈部。在第二例中，一名 4 岁男性出现了非瘙痒性的黑色、扁平、非红斑性病变，且未进展。该患者的哥哥在 1 周前被诊断为毒葛性皮炎，他们在同一家日托中心，据认为是在那里接触到了毒葛。在这两例中，均诊断为黑斑漆树皮炎。黑斑漆树皮炎是由于接触空气后漆酚氧化引起的。接触后，患者可能会或可能不会发展为过敏性接触性皮炎。这种皮炎的诊断基于临床表现，需要仔细考虑病史、分布和病变形态。如果像第一例那样确实发生了过敏性皮炎，建议口服类固醇进行全身性治疗。在这两例中，黑色斑点在 2 至 3 周内完全消退。如果皮肤病未按预期消退，可能需要皮肤科转诊进行皮肤镜检查和活检。
