Recurrent Rash Secondary to Shiitake Dermatitis

Case Report

J Fam Med. 2021; 8(3): 1250.

Recurrent Rash Secondary to Shiitake Dermatitis

Nguyen L¹ and Prodanovic E²*

¹Doctor of Medicine Program, Eastern Virginia Medical School, USA

²Texas Skin Center, Houston, Texas, USA

*Corresponding author: Prodanovic E, Texas Skin Center, 4101 Greenbriar Drive, Suite #305, Houston, Texas 77098, USA

Received: March 30, 2021; Accepted: April 14, 2021; Published: April 21, 2021


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.

Keywords: shiitake mushrooms; Shiitake dermatitis


Shiitake dermatitis is a cutaneous reaction from ingesting shiitake mushrooms, which contain a polysaccharide, lentinan that is hypothesized to cause the inflammatory response. The characteristic presentation is pruritic plaques in a linear or flagellate pattern that resembles marks from a whip. Shiitake dermatitis can be distinguished from other similar cutaneous reactions through history and histology. It is typically self-limiting and treatment focuses on symptom management. Since its first description in 1977, shiitake dermatitis has been documented in multiple patients [1]. The following case report is of an individual initially assumed to have an adverse drug reaction and upon a repeat occurrence, was found to have shiitake dermatitis.

Case Presentation

The patient was a 56-year-old, morbidly obese female with a history of insulin-dependent diabetes mellitus, hypertension, and chronic pain. For a recent upper gastrointestinal endoscopy, she received propofol and in February 2019, she presented with a diffuse erythematous rash. The rash began from the chest and spread to the extremities, with reported pruritus, pain, and fever. The palms and soles were relatively spared. Following a febrile episode, she was admitted to the emergency department for a period of one week. White blood count was elevated with a high of 17.5 x 109/L and lymphocyte percentage was decreased with a low of 17%. Hemoglobin and hematocrit decreased to 9.9g/dL and 30.4%, respectively. The rash was diagnosed as a drug eruption and hydrochlorothiazide was removed from the patient’s medications.

In March 2019, the patient experienced a recurrence of symptoms. The trunk and extremities were covered in pruritic linear papules and suggestive of a flagellate pattern (Figure 1).

Citation:Nguyen L and Prodanovic E. Recurrent Rash Secondary to Shiitake Dermatitis. J Fam Med. 2021; 8(3): 1250.