Questions about poison sumac

[Silentknight]

It's the middle of December. The deciduous plants of North Jersey have all shed their leaves or died. So why the hell does there still seem to be poison sumac around?

I do not remember having handled any of the stuff this year. The last time I touched any of it without gloves on was the summer before last. After that unfortunate incident, I scrubbed out the waste barrels I had used to dispose of it, I sprayed brush killer on every last part of the vine I could reach, and I never did any weeding without having gloves on. I thought that would be the end of it. I was wrong.

I have no idea what caused this recurrence, but about a week ago the angry blistering urushiol rash came back on two of the fingers on my right hand. It's always on the same fingers, the third and fifth. For some reason it never reappears on the others, and it always seems to reappear spontaneously even though I don't know what I could have touched to trigger it. The only thing that comes to mind is that I put on the same disposable vinyl gloves from when I had previously worked outside to rake leaves, but the oil should not have gotten inside them.

I do have a small bottle of the Tecnu cleanser (http://www.teclabsinc.com/products.cfm?id=1F5604C8-9D05-4675-56129F6D83DF2417&section=1) which is supposed to help, but it doesn't do much good if the poison rash is already present, especially if I have no idea how I got it this time.

I put this in the Science & Medicine section because my questions are related to those fields. Why would the poison rash come back on the same two fingers every single time? How dangerous is the plant if the leaves have fallen off for the winter? What precautions have I not been taking?

[paximperium]

It doesn't sound right.

Do you get oral/mouth ulcers(cold sores) ie. herpes?
If you get herpes on your fingers(herpetic whitlow), they usually look like this:
http://www.visualdxhealth.com/images/dx/webAdult/herpeticWhitlow_2665_lg.jpg

[Ixion]

My thoughts echo Paximperium's. I was wondering if you are not just seeing a Herpes Zoster rash? Have you been to a doctor?

ETA: Zoster doesn't usually seem to crop up as often on the hands/feet as it does the face or trunk, but anything is possible.

[Silentknight]

Ah, the chickenpox / shingles virus. No, the blisters are very tiny and they itch rather than hurt, though most of the time I don't feel anything or even notice them unless I look very closely. They have appeared only on those two fingers and on my elbows, and nowhere else, though I have to admit that the recurrence is a little suspicious. My physician did say it was a poison rash and simply recommended calamine lotion.

The one possible cause I can think of is that the leaves I raked included some of the poison sumac leaves, since they all kind of landed together. This means the urushiol could have gotten on the rake, the shovel, and the plastic sheet I was using to move them, all of which I've handled since then without having gloves on. What seemed to trigger this latest episode was putting the same gloves on my hands instead of wearing new ones.

It's probably worth mentioning that there is a member of my family who has eczema. Some of my symptoms are similar, but I've never been diagnosed. The recurring rash on my elbows has a strong resemblance to it, and I have something similar on the sides of my neck. In these cases though, there's no blistering, just inflammation and dryness respectively.

I don't get mouth sores except for tiny ones on the inside, such as behind my right molars, a few times a year. (I mean this when I say this: I haven't had any contact with anyone who could have spread HSV I to me.) I still suspect it's a poison rash, but if I do see a doctor about my hand, what would the possible treatment options be?

[casebro]

There's got to be something better than calomine, isn't there? Benedryl? Cortisone? Claratin pills?

But also, allergies can break out form exposure elsewhere. My brother was allergic to Cocobolo wood. Inhaling the vapors made his skin break out in the usual prickly heat areas, regardless of how tightly he zipped himself into long clothes, rubber gloves, etc.

[Patsy]

No, the blisters are very tiny and they itch rather than hurt, though most of the time I don't feel anything or even notice them unless I look very closely. They have appeared only on those two fingers and on my elbows, and nowhere else, though I have to admit that the recurrence is a little suspicious.

This sounds very much like my Excema to me, tiny, invisible itchy blisters in the same place over and over. GPs are (in my experience) terrible at diagnosing rashes. Skip the GP and head for the dermatologist.

[king catfish]

Do a google search on "dishydrotic Excema". I get this too and it drives me nuts. :(

[sol invictus]

Try Elidel/Protopic. Does wonders for excema on many people.

[Tiktaalik]

Poison oak, poison ivy, and I believe also poison sumac all have the oils, which cause the irritation, in the stems as well as the leaves. So if you walk through a patch of defoliated PI/PO, you can still get the rash. It's more likely to occur in strips rather than patches. So it's possible you got it from handling stems without leaves on them. I've had PI in December a number of times since I hike off-trail until the snow flies.

[Careyp74]

Do a google search on "dishydrotic Excema". I get this too and it drives me nuts. :(

I second that. I get it every time it starts getting cold, same exact places and same shapes. Last time was a week ago (I live close to Jersey, btw, so similar climates)

[luchog]

This sounds very much like my Excema to me, tiny, invisible itchy blisters in the same place over and over. GPs are (in my experience) terrible at diagnosing rashes. Skip the GP and head for the dermatologist.

I was thinking the same thing; and strongly second that recommendation.

[king catfish]

Well, I am in the middle of an outbreak of this, very severe on my hands. After two nights of nearly no sleep from the intense itching and burning and trying everything under the sun, including oatmeal, lotions, benadryl (topical and pills), ice packs, even Vicodin, I went to the doctor. I was there for a referral to a dermatologist, but no derm would see me before July (!) even though I begged for relief. My GP claimed to know about this stuff and saved me the trip, prescribing fluocinonide, a potent corticosteroid. He cautioned me how to use it, BTW.

I applied it once today and my hands were almost immediately better. I think I will be able to sleep tonight.

Even though my (current) GP seems enlightened about dyshidrotic excema, I have been to various doctors over the years with this, and this is the first doctor (of 10? 15?) that knew anything about it. So if you can get an appointment with a dermatologist, that's your better bet.