title: Treatment of severe poison ivy: a randomized, controlled trial of long versus short course oral prednisone.
abstract: BACKGROUND
  Toxidendron (poison ivy, oak, and sumac) contact dermatitis is a common complaint in the outpatient primary care setting with little evidence-based guidance on best treatment duration.
  
  
  METHODS
  This randomized, controlled trial examined the efficacy and side effects of a 5-day regimen of 40 mg oral prednisone daily (short course) compared to the same 5-day regimen followed by a prednisone taper of 30 mg daily for 2 days, 20 mg daily for 2 days, 10 mg daily for 2 days, and 5 mg daily for 4 days over a total of 15 days (long course) in patients with severe poison ivy dermatitis.
  
  
  RESULTS
  In 49 patients with severe poison ivy, non-adherence rates, rash return, medication side effects, and time to improvement and complete healing of the rash were not significantly different between the two groups. Patients receiving the long course regimen were significantly less likely to utilize other medications (22.7% vs. 55.6%, P = 0.02, number needed to treat 3.05).
  
  
  CONCLUSIONS
  This study suggests that a longer course prescription may save patients' time and exposure to excess medication in the treatment of severe poison ivy. Application of this information to clinical practice will save return visits and reduce excess non-prescription medication administration to individual patients.
authors.affiliation: Cox Family Medicine Residency, 1423 North Jefferson, Springfield, MO 65802, USA.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Curtis
authors.affiliation: Breech School of Business, Drury University 900 North Benton Avenue, Springfield, MO 65802, USA ; Primary Care Health Improvement Project Practice Based Research Network, 1423 North Jefferson, Springfield, MO 65802, USA.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Lewis
keywords: Contact dermatitis; Poison ivy; Steroid taper; Toxidendron