Shiitake Dermatitis Research Articles

002 Shiitake dermatitis: Not mush-room for shrooms

In rare occasions, ingestion of raw or undercooked shiitake mushrooms (Lentinus edodes) can result in a unique dermatologic manifestation known as shiitake flagellate dermatitis (SFD). The diagnosis of SFD is often overlooked due to the rarity of the condition and the commonality of shiitake mushroom consumption. As the consumption of shiitake mushrooms increases globally, a rise in cases may follow suit. Therefore, awareness of the presentation and clinical background of SFD is critical. Here, we present a case of SFD in a middle-aged female.

Shiitake dermatitis: experience of the Poison Control Centre Network in France from 2014 to 2019

Objective Shiitake mushrooms (Lentinus edodes) are an edible fungus, initially grown in Japan and China that are increasingly marketed in Europe. We previously presented 15 shiitake dermatitis cases reported to Poison Control Centres (PCCs) in France from January 2000 to December 2013. The aim of this study was to describe changes in the number of shiitake dermatitis cases since 2014, and to better describe the clinical characteristics and risk factors of this reaction. Case series This observational study is a retrospective review of cases in the French PCCs database between 1 January 2014 and 31 December 2019. Out of 125 shiitake exposures, we identified 59 cases of dermatitis: sex ratio of 1.80 M/F; ages ranging from 19 to 69 years (median: 39 years). Dermatitis occurred after raw or undercooked shiitake consumption (e.g., from the wok, in soup, or on pizza). The rash appeared 1–168 h (median: 48 h) after shiitake ingestion. Linear, erythematous, urticarial papules and plaques developed across the trunk, arms, and legs within a few hours and persisted for 1–40 d (median 10 d). The amount of shiitake eaten (low vs. medium vs. high) significantly increased the duration of dermatitis (median days 4 vs. 7 vs. 15, respectively; p = .007). In all, 38 patients received corticosteroids, antihistamine drugs, or both without demonstrated benefit. All patients made a complete recovery. Conclusions The mechanism of shiitake dermatitis is thought to involve lentinan, a heat-labile polysaccharide component. Inadequate cooking clearly seems to be a driver of the occurrence of shiitake dermatitis. This study highlighted a dose-dependent response, suggesting a partial toxic mechanism or a th1-type hypersensitivity mechanism. Treatment is focused on symptom management. Health professionals and the general population should be aware of both the risk associated with inadequately cooked shiitake consumption and the favourable prognosis of this still poorly known toxic dermatitis.

Flagellate Erythema: A Case of Shiitake Dermatitis and Review of Pathogenesis

Shiitake dermatitis is a rare eruption that is associated with the ingestion of uncooked shiitake mushrooms, resulting in a distinctive flagellate erythema. It was initially hypothesised that the mechanism of disease related to a toxic reaction to lentinan; however, recent evidence has suggested a potential allergic mechanism. The authors herein present a case of shiitake dermatitis and review the current understanding of pathogenesis of this condition and flagellate morphology. With an increase in consumption of shiitake mushrooms in Western society, shiitake dermatitis is expected to become more prevalent worldwide.

Flagellate Erythema: A Case of Shiitake Dermatitis and Review of Pathogenesis

Shiitake dermatitis is a rare eruption that is associated with the ingestion of uncooked shiitake mushrooms, resulting in a distinctive flagellate erythema. It was initially hypothesised that the mechanism of disease related to a toxic reaction to lentinan; however, recent evidence has suggested a potential allergic mechanism. The authors herein present a case of shiitake dermatitis and review the current understanding of pathogenesis of this condition and flagellate morphology. With an increase in consumption of shiitake mushrooms in Western society, shiitake dermatitis is expected to become more prevalent worldwide.

Recurrent Rash Secondary to Shiitake Dermatitis

Ingestion of shiitake mushrooms can result in a cutaneous reaction known as shiitake dermatitis. In this case report, a recurrent rash in a 56-yearold female patient was found to be shiitake dermatitis. The clinical features, histology, and relevant literature are discussed in the context of differentiating shiitake dermatitis from other similar cutaneous reactions.

Shiitake dermatitis: a case report and review of the medical literature

La dermatitis shiitake es una reacción cutánea causada por la ingestión de setas shiitake crudas o poco cocinadas. Su fisiopatología no se comprende completamente, pero se sugiere que se debe al Lentinan, un polisacárido termolábil que se encuentra en la pared celular del hongo. La erupción dermatológica se manifiesta con pápulas eritematosas lineales, en un patrón flagelado, asociadas a prurito intenso y generalmente involucra el tronco y las extremidades. Es una afección autolimitada, aunque los síntomas se pueden tratar con medicamentos antihistamínicos y corticoides tópicos. Se presenta el caso de un paciente masculino caucásico de 28 años, sin antecedentes patológicos, quien consultó por aparición de lesiones cutáneas 72 horas después de la ingesta de setas shiitake. Hay un aumento en la ingestión de este hongo en los países occidentales, por lo que los profesionales de la salud y dermatólogos deben conocer las lesiones cutáneas características asociadas a su consumo.

Clinical features of shiitake dermatitis: a systematic review.

Shiitake dermatitis is a rare cutaneous reaction to lentinan, a polysaccharide component in the cell walls of shiitake mushrooms (Lentinula edodes). Herein, we systematically review the case report and case series English-language literature on shiitake dermatitis, which refers to a total of 50 patients (38 males, 12 females; mean age: 44.58years). The majority of cases occurred after the consumption of raw mushrooms, whereas 22% of cases were caused by the eating of lightly or undercooked mushrooms. The most common clinical presentations, localized symptoms, and systemic findings include linear flagellated dermatitis (98%), pruritus (78%), and fever, diarrhea, and mucosal ulcers, respectively. The diagnosis of this entity continues to be based on clinical findings as laboratory abnormalities, and the findings of skin biopsies and patch/prick tests are nonspecific and inconsistent. The condition is self-limiting, resolving in approximately 12.5d without treatment. Based on the included case reports, it appears that medical treatment may slightly shorten the course of disease (to 9-11d, varying by therapy) but should be considered on an individual patient basis. However, the treatment of symptoms, reassurance, and the avoidance of re-exposure are sufficient treatment recommendations for this condition.

Shiitake Dermatitis-like Eruption Due to Tegafur/Gimeracil/Oteracil Combination Usage

S-1 is a combination drug of tegafur, gimeracil and oteracil potassium that is designed on the basis of 5- fluorouracil. We report here for the first time that S-1 is a causative agent of drug eruption mimicking shiitake dermatitis. A 58-year-old Japanese man presented with pruritic erythemas arranged in a linear fashion. He had been treated with S-1 for esophageal cancer. Although differential diagnosis included shiitake dermatitis and dermatomyositis, he had not eaten raw shiitake mushroom, and he did not have other cutaneous lesion such as Gottron's sign and abnormalities of peripheral blood examination including Jo-1 antibody and antinuclear antibody. Histopathological examination revealed necrotic keratinocytes in the Malpighian layer, vacuolar change in the basal layer, and lymphocytic and eosinophilic infiltration in the upper dermis. Based on clinical and histological findings, we made a diagnosis of drug eruption due to S-1.

P332 A case of shiitake mushroom-induced flagellate dermatitis

P332 A case of shiitake mushroom-induced flagellate dermatitis

Annual report of the Emerging Risks Exchange Network 2015

Annual report of the Emerging Risks Exchange Network 2015

Shiitake dermatitis in a 5-year old boy: First pediatric case report

Shiitake mushrooms are increasingly being consumed in the West because of their possible health benefits and changing dietarypreferences. A rare but increasingly occurring undesired effect caused by the thermolabile polysaccharide lentinan in the Shiitakemushroom is the incidence of a particular toxic dermatitis called flagellate dermatitis or Shiitake dermatitis. This dermatitis isextremely pruritous, heals without scarring in one to eight weeks and the effect of treatment is doubtful. The pathogenesis has notbeen completely explained and it is unclear why some people react more than others. We here present what we believe to be thefirst pediatric case of Shiitake dermatitis in a 5-year-old boy.

Shiitake Dermatitis – Now Also in Poland

Shiitake dermatitis is a striking skin reaction that may appear after consumption of raw or undercooked Shiitake mushrooms (Lentinus edodes) in susceptible individuals. The disease is also termed flagellate mushroom dermatitis because the skin lesions resemble wounds caused by whip (flagellum in Latin) (1, 2). It was first described in Japan by Nakamura (3) in 1977 and to date only few cases were reported in Europe (2, 4, 5).

Shiitake dermatitis recorded by French Poison Control Centers – new case series with clinical observations

Context. Shiitake (Lentinula edodes) is an edible mushroom which was initially grown in Japan and China and is now sold on the European market. Flagellate erythema may arise following shiitake consumption and was first described in Japan in 1974. Objective. This paper reports a French shiitake dermatitis case series. Methods. The findings of retrospective study of shiitake dermatitis cases, reported to French Poison Control Centres (PCC) from January 2000 to December 2013, are reported. Results. Among 32 exposed patients, 15 presented flagellate urticarial lesions after raw shiitake consumption. The first case of this series was reported in 2006 and the last nine cases were reported as of 2012. After shared meals, no symptoms were reported among guests, who preferred cooked shiitake to the raw mushroom. In this series, rashes appeared 12 h to 5 days (median: 24 h) after raw shiitake ingestion. Linear and itchy urticarial lesions formed on the trunk, arms, and legs within a few hours and persisted for 3–21 days. In four cases, rash and pruritus were either triggered or worsened by sun exposure. Eleven patients received corticosteroids, antihistamines, or both. All patients completely recovered. Conclusion. Due to the rapidly increasing consumption of exotic food in Western countries, it is no surprise that cases of shiitake dermatitis are now appearing in Europe. The mechanism of shiitake dermatitis is thought to be toxic and due to lentinan, a polysaccharide component of the mushroom. There is no specific validated treatment for shiitake dermatitis. Health professionals and the general population should be aware of both the risk associated with raw shiitake consumption and of the good prognosis of this very spectacular and uncomfortable toxic dermatitis.

Shiitake dermatitis: the first case reported in Brazil

Shiitake Dermatitis is often presented as papules and erythemato-violaceous linear streaks. It can be associated with bleomycin treatment, dermatomyositis and shiitake mushroom (Lentinus edodes). There is not any previous report concerning this rare etiology in our country. Shiitake is the second most consumed mushroom worldwide and it can cause flagellate erythema when ingested raw or half cooked. It has a higher incidence in Oriental countries because of their eating habits, this is the first case reported in Brazil, in a male patient that presented a cutaneous rash after consuming this raw mushroom.

Analysis allergic reactions in two patients with anaphylaxis induced by the ingestion of shiitake mushroom

Shiitake are popular edible mushrooms all over the world, and eating raw shiitake may lead to relatively common shiitake dermatitis or toxicoderma. There are few reports of immediate allergy from shiitake mushroom. We report two cases of anaphylaxis that occurred immediately following the ingestion or touching of shiitake mushroom. However shiitake mushroom allergen which has so far been identified and characterized. The aim of our study was to analysis allergic reactions in two patients with anaphylaxis induced by the ingestion of shiitake mushroom.The two patients were 42 year-old, female office worker (case 1) and 35 year-old, male shiitake grower (case 2).

Clinical variability of shiitake dermatitis

Clinical variability of shiitake dermatitis

Treatment of shiitake dermatitis by balneo PUVA therapy

To the Editor: Shiitake (Lentinus edodes) dermatitis, also called toxicoderma, is a characteristic acute skin reaction that occurs after eating raw or half-cooked shiitake. Shiitake are semi-toxic mushrooms that contain the heat-labile toxin lentinan.1-3 Shiitake dermatitis mainly occurs in Japan, although these mushrooms are also cultivated worldwide. Thus shiitake dermatitis has become more common in recent years in Europe and the United States. Multiple cases have been published since the first report by Nakamura1 in 1977, but to date there is no effective therapy.

La shiitake dermatitis (dermatose toxique au lentin) est arrivée en France

In Asia, toxic adverse effects due to picking or consumption of shiitake mushrooms (Lentinula edodes), the second most eaten mushroom in the world are well-known. Its increasing consumption in Europe, let us to emphasize that shiitake dermatitis would occur more and more frequently in Occident. A 78-year-old woman was referred for an erythematous, micro-papular, extremely pruriginous rash disseminated all over the body (including face and scalp). No drugs had been recently introduced. Questioning revealed that lesions appeared 48 hours after eating a great quantity of raw shiitake mushrooms, leading to the diagnosis of shiitake dermatitis. Clinical features of shiitake dermatitis are small, highly pruriginous, erythematous papules, generalized. They have a whole body spreading and in some area a linear disposition. It is a toxic reaction due to a toxin called lentinan. It occurs in the 48 hours after having eaten raw or slightly cooked mushrooms and vanishes into 10 days. Due to its increasing consumption in Occident, it is essential for European dermatologists to know this dermatosis and how to recognize it.

Shiitake Dermatitis Diagnosed After 16 Years!

Shiitake dermatitis is a condition that commonly occurs in Asian countries and has been recently reported in Europe. We report a case diagnosed after a 16-year history of an intermittent flagellate eruption.

Shiitake dermatitis: the first case reported from a European country

Shiitake dermatitis: the first case reported from a European country