September 11, 1991

Failure of a Tapering Dose of Oral Methylprednisolone to Treat Reactions to Poison Ivy

Author Affiliations

University of North Carolina at Chapel Hill School of Medicine

University of North Carolina at Chapel Hill School of Medicine

JAMA. 1991;266(10):1362. doi:10.1001/jama.1991.03470100054031

To the Editor.  —During the poison ivy season, the use of an oral corticosteroidtapering regimen is prescribed routinely for cases unresponsive to topical preparations. One of the most commonly prescribed corticosteroid products, Medrol Dosepak (Upjohn Co, Kalamazoo, Mich), is a 6-day tapering course of oral methylprednisolone. Anecdotal reports abound about flare-ups of severe cases of Rhus dermatitis within several days after completion of this product, but no documentation of this reaction exists, either in the medical literature or from the manufacturer. We have found that a tapering dose of prednisone over 12 days has not been associated with another flare-up of symptoms in severe cases of Rhus dermatitis. We report the use of this regimen in a case that is representative of this patient population.

Report of a Case.  —A 32-year-old woman presented with a complaint of recurrent poison ivy for the past 5 days. While backpacking 2 weeks previously,