Flagellate dermatitis after consumption of Shiitake mushrooms

Abstract

Flagellate dermatitis occurs in patients who have eaten Shiitake mushrooms. We are reporting on a 55-year-old man, who developed whiplash-striped, severely itching efflorescences on the trunk 3 days after eating Lentinula edodes. Flagellate dermatitis is also known as a cutaneous side effect of bleomycin therapy.

Flagellate dermatitis and flagellate erythema: report of 4 cases

“…Shiitake ( Lentinus edodes ) is a type of mushroom used in Japanese/Chinese cuisine as well as in traditional Asian medicine due to its antihypertensive, cholesterol‐lowering, and anti‐carcinogenic properties . FD after the consumption of raw or half‐cooked SM was first described in 1977 .…”

“…Forty‐eight hours after consuming SM, the patients develop small and erythematous papules grouped in linear and parallel streaks reminiscent of whiplash lesions that can be moderately itchy. The most affected areas are the trunk, extremities, and the nape area of the neck; less frequently affected are the face and scalp .…”

“…The most affected areas are the trunk, extremities, and the nape area of the neck; less frequently affected are the face and scalp . The histology of FD is unspecific, presenting as epidermal spongiosis and perivascular, dermal lymphocytic infiltrate . Lentinus edodes has a thermolabile polysaccharide – lentinan – which is considered responsible; nevertheless, the pathogenesis is not yet completely understood.…”

“…Flagellate dermatitis (FD) and flagellate erythema (FE) are two clinically similar dermatoses composed by multiple lineal and parallel streaks . FD usually appears 48 h after consumption of raw or half‐cooked Shiitake mushrooms (SM), whereas FE is a drug reaction caused by bleomycin or bendamustine .…”

Shiitake dermatitis

“…2,3 The pathogenesis of shiitake dermatitis remains unclear. Koebnerization is unlikely because scratching usually does not reproduce the rash.…”