Shiitake dermatitis L30.9

Author: Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 29.10.2020

Dieser Artikel auf Deutsch

Synonym(s)

Flagellant dermatitis; shiitake dermatitis

History
This section has been translated automatically.

Nakamura, 1977

Definition
This section has been translated automatically.

Stripy dermatitis after consumption of the edible mushroom shiitake (Lentinus edodes). Auricularia auricula-judae, the Judas ear, a beta-glucan-containing saprophytic fungus of the class of agaricomycetes, can also cause analogous clinical symptoms.

You might also be interested in

Allergology

6-keto-prostaglandin f1alpha

6-keto-prostaglandin F1alpha is the physiologically active and stable metabolite of prostaglandin GI2 (PGI2...

Advertisment

Occurrence/Epidemiology
This section has been translated automatically.

About 100 cases have been described worldwide, mostly in Japan. In Europe only very rarely occurring.

Etiopathogenesis
This section has been translated automatically.

Lentinan, a (thermolabile! water-soluble) polysaccharide from Lentinus edodes, which is also used in Japan for tumour therapy, is assumed to be the triggering agent. Dermatitides have also been described here. This is probably a toxic reaction. Apparently, more type IV reactions than type I reactions are detected. In mushroom growers with allergic contact dermatitis positive immediate reactions could be triggered in prick tests (Wagner G 2011).

Localization
This section has been translated automatically.

neck, trunk (see picture), extremities, rare face

Clinical features
This section has been translated automatically.

Hours after consumption of a dish containing shiitake, occurrence of flat, massively itching erythema, which is answered with violent scratching reactions. In the scratch marks, striped, parallel arranged, persistent erythema develop, which develop into correspondingly arranged papulo-vesicles. Skin symptoms persist for weeks. They heal without postimflammatory hyperpigmentation.

Histology
This section has been translated automatically.

Cancellous dermatitis with dense perivascular and interstitial lymphomonocytic infiltrates with eosinophilia in the upper and middle dermis.

Differential diagnosis
This section has been translated automatically.

Melanodermia factitia (skin changes caused by bleomycin)

External therapy
This section has been translated automatically.

Topical glucocorticoids, possibly under occlusion.

Internal therapy
This section has been translated automatically.

Systemic antihistamines such as desloratadine (Aerius) once/day 5 mg p.o. or levocetirizine (Xusal) once/day 5 mg p.o. In the case of highly acute courses, systemic glucocorticoids such as prednisolone (Decortin H) initially 100-150 mg/day p.o. for a short time, creeping out within one week.

Note(s)
This section has been translated automatically.

The shiitake mushroom is the second most common cultivated mushroom in the world, has a similar taste to the porcini and is used in fresh form, steamed or dried, especially in Asian cuisine. Its cap grows up to 20 cm wide and is brown-grey to brown in colour with pressed triangular scales. Its lamellae are white-brownish, the spores colourless.

Literature
This section has been translated automatically.

Haas N et al (2001) Shiitake dermatitis. Dermatologist 52: 132-135
Hiernickel C et al (2015) Shiitake dermatitis: an impressive case report. dermatologist 66: 455-456
Lang N (2016) Striated, whiplash erythema and succulent papules: Flagellate dermatitis after consumption of Auricularia auricula-judae. JDDG 14: 303-304
Nakamura T (1977) Toxicoderma caused by shiitake (Lentinus edodes) in Japan. Jpn Clin Dermatol 31: 65-68
Wagner G et al (2011) Shiitake dermatitis. Linear grouped erythema and papules on the upper trunk and décolleté. J Dtsch Dermatol Ges 9: 555-557.