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Flagellate Dermatitis Induced by Shiitake Mushrooms—Clinical Features of a Rare but Characteristic Entity

Title: Flagellate Dermatitis Induced by Shiitake Mushrooms—Clinical Features of a Rare but Characteristic Entity
Authors: Daniel Nette; Patrycja Rogowska; Martyna Sławińska
Source: Diagnostics ; Volume 16 ; Issue 5 ; Pages: 692
Publisher Information: Multidisciplinary Digital Publishing Institute
Publication Year: 2026
Collection: MDPI Open Access Publishing
Subject Terms: flagellate dermatitis; flagellate erythema; shiitake dermatitis; dermatitis; hypersensitivity
Description: We present the case of a 25-year-old male who attended a dermatological online consultation due to a whiplash-shaped, pruritic rash. The lesions in the form of well-demarcated linear erythematous papules, located mainly on the trunk and arms, had first appeared four days prior to the consultation. Chronic disease history was negative and similar symptoms never appeared previously. After reviewing the clinical images and excluding dermatographism, flagellate dermatitis was suspected. The diagnosis was subsequently confirmed when the patient reported having consumed undercooked shiitake mushrooms two days prior to the onset of the lesions. Topical corticosteroids and oral antihistamines were recommended, and the patient was informed about the necessity of high-temperature preparation of shiitake mushrooms in the future. Flagellate dermatitis is a rare entity speculated to be a hypersensitivity reaction to lentinan, a heat-labile polysaccharide found in shiitake mushrooms (Lentinus edodes). Symptoms include characteristic papular or vesicular lesions erupting in a linear pattern resembling whiplash marks, usually on the trunk and extremities. While the condition is self-limiting, the awareness of its manifestation is important in order to prevent unnecessary biopsies. Patients should be educated to avoid further exposure to lentinan, as instances of severe reactions following repeated contact have been described.
Document Type: text
File Description: application/pdf
Language: English
Relation: Clinical Diagnosis and Prognosis; https://dx.doi.org/10.3390/diagnostics16050692
DOI: 10.3390/diagnostics16050692
Availability: https://doi.org/10.3390/diagnostics16050692
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.D8B70958
Database: BASE