LAUSR

Shiitake dermatitis: a case report of a rare mushroominduced dermatitis in the United States Dear Editor, A 42-year-old previously healthy male presented to the clinic with a pruritic and erythematous linear rash located on the legs, buttocks, back, and trunk. The patient denied other systemic symptoms such as cough, fever, muscle weakness, or lymphadenopathy. The patient reports ingesting mushrooms in Chinese food about 48 hours prior. He denied the use of any new medications, outdoor activities such as landscaping, or changing of personal hygiene products. Upon physical examination, the patient presented with erythematous maculopapular rashes that were widespread over his body, but most concentrated on the legs, buttocks, back, and abdomen. There were also papules in a linear design as well as satellite papules. An intramuscular Kenalog injection was administered, and a 20-day oral prednisone regimen was prescribed. The patient achieved complete remission by day 10 (Figs. 1 and 2). Shiitake dermatitis is a relatively rare skin rash appearing most commonly around 48–72 hours after the ingestion of raw shiitake mushrooms (Lentinula edodes). It was discovered in Japan in 1977 by Nakamura. Since 1977, there have been less than 100 reported cases of shiitake dermatitis. There is a risk for shiitake dermatitis when raw or undercooked shiitake mushrooms are eaten by susceptible individuals. There is very little information about the underlying pathophysiology of this condition, however, the polysaccharide lentinan seems to play a role