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Flagellate Mushroom Dermatitis

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

A woman in her 50s presented with a 4-day history of a diffuse, progressive, and pruritic rash. She had no known allergies and did not take any medications. She had no exposures to chemicals, detergents, or new personal care products; however, the patient consumed raw shiitake mushrooms several days before symptom onset. An examination revealed dozens of long flagellate streaks composed of red papules distributed across the trunk and extremities (Figure). She denied fever, malaise, or dyspnea. Laboratory results were remarkable for eosinophilia. The findings and history were consistent with flagellate mushroom dermatitis. The patient was treated with topical steroids, oral antihistamines, and raw shiitake mushroom avoidance, and the condition improved without sequelae.

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Article Information

Published Online: April 20, 2022. doi:10.1001/jamadermatol.2022.0605

Correction: This article was corrected on May 18, 2022, to fix an error in the corresponding author’s address.

Corresponding Author: Jade N. Young, BS, Oregon Health and Science University, School of Medicine, 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3098 (jadeyoung715@gmail.com).

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank the patient for granting permission to publish this information.

References
1.
Nakamura  T .  Shiitake (Lentinus edodes) dermatitis.   Contact Dermatitis. 1992;27(2):65-70. doi:10.1111/j.1600-0536.1992.tb05211.xPubMedGoogle ScholarCrossref
2.
Suzuki  M , Takatsuki  F , Maeda  YY , Hamuro  J , Chihara  G .  Antitumor and immunological activity of lentinan in comparison with LPS.   Int J Immunopharmacol. 1994;16(5-6):463-468. doi:10.1016/0192-0561(94)90037-XPubMedGoogle ScholarCrossref
3.
Mendonça  FMI , Márquez-García  A , Méndez-Abad  C ,  et al.  Flagellate dermatitis and flagellate erythema: report of 4 cases.   Int J Dermatol. 2017;56(4):461-463. doi:10.1111/ijd.13523PubMedGoogle ScholarCrossref
4.
Chen  YB , Rahemtullah  A , Breeden  E , Hochberg  EP .  Bleomycin-induced flagellate erythema.   J Clin Oncol. 2007;25(7):898-900. doi:10.1200/JCO.2006.09.7691PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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