Month: July 2016

Rashes from Plants

The Allergists McLean VA Trust for Plant Rash Treatment
With the advent of summer, many people in Gainesville, VA, Falls Church, VA, Tysons Corner, VA, as well as the rest of the Washington, DC metropolitan area, are experiencing various types of rashes after outdoor activities.

“Irritant contact dermatitis” develops in individuals with very sensitive skin when they handle plants with prickles or barbs.  Some other type of plants cause skin reactions only in people who are previously sensitized to them.  This is called “allergic contact dermatitis.”  Physical contact of the skin with oil from these plants, called urushiol, is usually the culprit in these instances.

Poison ivy, poison oak, and poison sumac are the common plants that produce urushiol and trigger inflammation of the skin.  They grow as shrubs in open fields, wooded areas, on the roadside, as well as in backyards and parks throughout Falls Church, VA, Gainesville, VA, and Tysons Corner, VA.

The offending oils can be found on the leaves, stems, flowers, and roots of these plants. Exposure to even a small amount of urushiol can result in a severe rash in susceptible people. Touching the plants directly or indirect contact through pets, tools, and/or clothing can lead to the rash.  Airborne exposure can also occur especially when the plants are burned.

The symptoms can start anywhere from a few hours to a few days after the contact and usually presents itself as redness, swelling, itching, and/or burning of the exposed areas of the skin.  The rash may get more severe over the next few days and form blisters of various sizes.  They are usually distributed in a linear or streaky pattern depending on the type of contact.  The fluid that oozes from the blisters does not contain urushiol and therefore is not contagious.

The diagnosis is established after a detailed history and physical examination.  No blood tests or X-rays are needed.  The characteristic appearance of the lesions and their distribution pattern provide useful clues.

Thoroughly rinsing the exposed area with large amounts of warm water as soon as possible after known contact with plants may help remove the offending oily resins to some extent. After the rash appears, some helpful treatments consist of the following:

  1. Cool compresses to the affected skin.
  2. Local application of soothing agents such as calamine lotion and/or oatmeal baths.
  3. Antihistamines like Benadryl (i.e., diphenhydramine) by mouth to help relieve itching.
  4. If the affected area is limited and the rash and itching are intense, a topical medium to high potency steroid cream may be prescribed by an allergist in McLean, VA or the DC area.
  5. In more severe cases, an oral corticosteroid course may be needed to reduce the inflammation and prevent progression.
  6. In case of secondary bacterial infection, antibiotics are sometimes required.

One to three weeks is the usual duration of the condition.  Future episodes can be prevented by the following:

  1. Familiarizing with the appearance of the plants in order to recognize and avoid exposure.
  2. Wearing protective clothing including long sleeves, pants, boots, and gloves before outdoor activities.
  3. Applying commercially available OTC barrier creams to the skin in order to reduce or prevent contact with the toxic oils.
  4. Thoroughly washing clothes and bathing pets with protective gloves after coming into contact with the plants.

The board certified allergists at Black & Kletz Allergy in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA have had many years of experience in treating poison ivy, poison oak, and poison sumac and will readily answer your questions and address your concerns at any time.  In addition to treating poison ivy, poison oak, and poison sumac, we also diagnose and treat both adults and children with hay fever (i.e., allergic rhinitis), asthma, food allergies, medication allergies, sinus disease, immune disorders,  eczema (i.e., atopic dermatitis), hives (i.e., urticaria), swelling episodes (i.e., angioedema), and other types of skin rashes.  The 3 offices of Black & Kletz all have on-site parking and the Washington, DC and McLean, VA offices are Metro accessible.  There is a free shuttle that runs between our McLean, VA office and the Spring Hill metro station on the silver line.  If you suffer from allergies, please call our office to make an appointment or alternatively, you can click Request an Appointment and we will respond to you within 24 hours by the next business day.  The allergist McLean VA patients trust at Black & Kletz Allergy have been serving the allergy and asthma needs of the Washington, DC metro area for more than 50 years and we take pride in providing quality care in a friendly and professional environment.

It is the Summer – What You Should Know About Insect Sting Allergies

From Allergy Doctors Vienna VA Patients Trust
Now that the weather in Tysons Corner, VA, Gainesville, VA, and Falls Church, VA and the rest of the Washington, DC metropolitan area has warmed up, as it is now Summer, the risk of an insect sting has increased.  The most common stinging insects in the Washington, DC metro area are honey bees, yellow jackets, white-faced hornets, yellow-faced hornets, and wasps.  They all introduce their venom into their subjects when they sting their prey.  In some cases, people have toxic (i.e., non-allergic) reactions to the insect stings, particularly if stung by several insects at the same time.  The body, in this case, generally reacts to the venom as if it was a poison.  This can occur because the victim is exposed to an over-abundance of venom at one time.  A toxic reaction can cause symptoms similar to those of an allergic reaction, but also may include symptoms such as nausea, fever, and seizures.  This can be life-threatening and depends on the amount of venom injected into the individual.  On the other hand, about 3% of individuals experience true allergic reactions, which is usually not dependent on the amount of venom, but to the allergic response to the venom by the individual.  These allergic reactions can also be life-threatening.

When stung, most individuals have no reaction or a small local reaction.  People with this type of response are at no increased risk for a systemic (anaphylactic) reaction than that of the general population.  Other people will develop a large local reaction, where the area that was stung gets red and very swollen.  This large local reaction can reach the size of a baseball in some cases.  Still, however, there is no increased risk in these individuals of a systemic or anaphylactic reaction from the insect sting.  On the other hand, a small percentage of individuals will develop a systemic reaction to an insect sting which may include some or all of the following:  generalized itching (i.e., pruritus)hives (i.e., urticaria)swelling (i.e., angioedema) of another area of the body where the sting did not take place, abdominal cramping and pain, wheezing, shortness of breath, chest tightness, coughing, feeling faint, and drop in blood pressure.

If a person has had a large local reaction or a systemic reaction to an insect sting, they should definitely seek a consultation with a board certified allergist like the allergy specialists of Black & Kletz Allergy.  The allergists that Tysons Corner, VA, Falls Church, VA, Gainesville, VA, and Washington, DC residents have trusted for years have had over 50 years’ experience diagnosing and treating insect sting allergies.  A comprehensive history and physical examination is taken and then a decision is made whether to test that individual for allergies to honey bees, yellow jackets, white-faced hornets, yellow-faced hornets, and wasps.  Allergy testing can be done via blood or by skin tests.  The allergist will then decide the preferred method of testing for each specific individual, depending on the history of the reaction that is ascertained at the visit.

Measures in order to help prevent insect stings are discussed with patients, as well as what things should be done, if a future sting occurs.  For example, if stung by a honey bee, a stinger is left in the skin of the victim.  One should never pull out the stinger, as this actually increases the amount of venom that is introduced into the individual by causing contractions of the venom sac which is hidden under the skin of the person.  Instead, one should scrape off the stinger with a finger nail, credit card, etc. in order to prevent the introduction of more venom into the body of the individual.

If a patient has a positive allergy test to any of the stinging insect venoms, it is imperative that he/she go on a course of venom allergy immunotherapy (i.e., allergy shots, allergy injections, allergy desensitization) as it is extremely successful in preventing further anaphylactic reactions from insect stings.  The procedure entails giving progressively larger doses and volumes of insect venom to the individual weekly over a period of 10 weeks, then every 2 weeks for 1 dose, then every 3 weeks for 1 dose, then a maintenance dose every 4 weeks for 1 year, and then the maintenance dose can be decreased to every 6 weeks for several years.  The maintenance dose is roughly equivalent to the amount of venom in an actual sting.  Therefore, if someone gets stung while they are on a maintenance dose of venom immunotherapy, they are essentially getting the same dose of venom as they normally get every 6 weeks.  For this reason, they usually do not have a systemic reaction to the stinging insect, because they are protected due to the allergy shots.

All patients with allergic reactions to stinging insects are prescribed a self-injectable epinephrine device (e.g., EpiPen, Auvi-Q, Adrenaclick).  At Black & Kletz Allergy, individuals are taught the correct method on how to use, when to use, and what to do, after using these devices.  We have training devices that we use to show patients the proper way to use them.  As a general rule, if someone is stung by a stinging insect and experiences any systemic sign or symptom, they should use the self-injectable epinephrine device and go immediately to the closest emergency room.

Reach Out To The Allergy Doctors Vienna VA Patients Call For Relief
Insect sting allergies in cities such as Tysons Corner, VA, Falls Church, VA, and Gainesville, VA as well as others in the Washington, DC, Northern Virginia, and Maryland metropolitan area are not uncommon.  During the Summer and early Fall, there are more insect stings taking place and it is very important to take precautions to reduce the likelihood of getting stung.  The allergy doctors of Black & Kletz Allergy see both adults and children with insect sting allergies, in addition to other allergic disorders such as allergic rhinitis (i.e., hay fever), asthma, hives, swelling episodes, eczema, sinus disease, food allergies, medication allergies, and immune disorders.  We have offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA, all of which offer on-site parking.  The Washington, DC and McLean offices are Metro accessible and the McLean office offers a free shuttle that runs between the office and the Spring Hill metro station on the silver line.  Please call one of our offices to make an appointment or you can click Request an Appointment and we will respond to you within 24 hours by the next business day. Black & Kletz Allergy takes pride in providing excellent quality allergy, asthma, and immunology care to the Washington, DC metro area community in a friendly, convenient, and professional setting.