From the FDA Drug Label
Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: eczema psoriasis poison ivy, oak, sumac insect bites detergents jewelry cosmetics soaps seborrheic dermatitis Directions for itching of skin irritation, inflammation, and rashes: adults and children 2 years of age and older: apply to affected area not more than 3 to 4 times daily
The patient's rash is likely due to contact with a plant such as poison ivy, oak, or sumac.
- The treatment for this condition is hydrocortisone (TOP), which can temporarily relieve itching associated with minor skin irritations, inflammation, and rashes.
- Application instructions: apply to the affected area not more than 3 to 4 times daily for adults and children 2 years of age and older 1 1.
- For children under 2 years of age, consult a doctor before applying hydrocortisone (TOP) 1.
From the Research
The treatment for a patient with a papular, almost vesicular rash on both arms after touching a plant likely involves managing contact dermatitis with over-the-counter topical corticosteroids and oral antihistamines. First, wash the affected area thoroughly with soap and water to remove any remaining plant oils (urushiol). Apply over-the-counter topical corticosteroids like 1% hydrocortisone cream 2-3 times daily for 1-2 weeks to reduce inflammation. For symptomatic relief, use cool compresses for 15-20 minutes several times daily and take oral antihistamines such as diphenhydramine (Benadryl) 25-50mg every 6 hours or cetirizine (Zyrtec) 10mg daily to control itching, as seen in the management of papular pruritic eruption where oral antihistamines were found to be effective 2. Calamine lotion can also be applied to soothe the affected skin. For severe cases with extensive rash or significant discomfort, a healthcare provider may prescribe stronger topical steroids or a short course of oral prednisone (typically 40-60mg daily for 5-14 days, tapered down). These treatments work by suppressing the immune response that causes the rash, as contact dermatitis is an allergic reaction to plant compounds that trigger inflammation when they bind to skin proteins. Avoid scratching the rash to prevent secondary infection, and seek medical attention if the rash affects the face, genitals, or covers large body areas, or if signs of infection develop. It's worth noting that while other studies discuss various types of rashes, such as vesicular eruptions in different contexts 3, 4, 5, 6, the primary concern here is managing contact dermatitis caused by plant exposure. Given the information provided and the focus on recent, high-quality evidence, the most relevant guidance for treating a papular, almost vesicular rash after touching a plant aligns with managing contact dermatitis symptoms and preventing further irritation.