Shiitake dermatitis: two clinical forms of cutaneous presentation in the same patient / Dermatitis por shiitake: dos formas clínicas de presentación cutánea en un mismo paciente

La dermatitis por hongos Shiitake ocurre en un pequeño porcentaje de casos luego de la ingesta de este hongo en forma cruda o semi-cruda. Se manifiesta usualmente como una dermatosis flagelada localizada principalmente en la espalda y en forma más ocasional con otro tipo de lesiones incluyendo la urticaria, petequias y una dermatitis de contacto entre otras. Este estudio describe un paciente sano de 46 años con dos tipos diferentes de reacciones al hongo, espaciadas en el tiempo. Primero está la típica dermatosis flagelada luego de la ingesta del hongo Shiitake y un tiempo después luego de que se había mejorado completamente, un segundo rash en la forma de dermatitis de contacto con descamación y prurito de las manos y dedos luego de la manipulación del hongo. Según nuestro conocimiento, este es el primer caso con dos diferentes formas de presentación clínica de reacción alérgica al hongo Shiitake en el mismo paciente

Shiitake fungal dermatitis occurs in a small percentage of cases after ingestion of this raw or semi-raw mushroom. It usually manifests as flagellated dermatosis located mainly on the back and more rarely with other types of lesions, including urticaria, petechiae, and contact dermatitis, among others. This study described a healthy 46-year-old male patient who presented two different forms of reaction to mushrooms, spaced over time. First is the typical form of flagellated dermatosis after the Shiitake mushrooms ingestion, and shortly after, when fully recovered, with a second rash in the form of contact dermatitis with desquamation and itching of hands and fingers after the mushroom manipulation. To the best of our knowledge, this is the first case reported with two different cutaneous clinical forms of allergic reaction to Shiitake mushrooms in the same patient.

Eritema flagelado por ingesta de hongos Shiitake: reporte de caso / Flagellated erythema due to Shiitake mushroom intake: report of case

El eritema flagelado es una erupción cutánea poco frecuente con múltiples causas, dentro de las cuales se encuentra la ingesta de hongos shiitake crudos o semicrudos. Se postula que es secundario a una reacción de hipersensibilidad Th-1 producida por el lentinan, un polisacárido termolábil de la pared celular del hongo. En años recientes ha aumentado su incidencia en el mundo occidental debido a la creciente popularidad de la comida asiática, en la que los hongos shiitake son un ingrediente muy utilizado. El cuadro clínico se caracteriza por la aparición de lesiones eritematosas lineales pruriginosas principalmente en tronco y extremidades, de curso autolimitado. El diagnóstico es principalmente clínico, basado en el antecedente de ingesta reciente de hongos shiitake y el rash característico y el tratamiento es sintomático con antihistamínicos y corticoides tópicos u orales. A continuación, presentamos un caso de eritema flagelado en una mujer joven, secundario a ingesta de hongos shiitake, que se resolvió completamente en 2 semanas.

Flagellate erythema is a rare skin eruption with many causes, including the ingestion of raw or undercooked shiitake mushrooms. It is thought to be a Th-1 hypersensitivity reaction produced by lentinan, a thermolabile polysaccharide found in the cell wall of the mushroom. In recent years, there has been an increase in the number of cases due to the growing popularity of Asian cuisine, in which shiitake mushrooms are a central ingredient. The clinical presentation is characterized by the appearance of linear, erythematous, pruritic lesions mostly on the trunk and extremities, of self-limited course. Diagnosis is mainly clinical, based on the history of recent shiitake mushroom ingestion and the characteristic rash, and treatment is symptomatic, with antihistamines and topical or systemic steroids. In this report, we present a case of flagellate erythema in a young woman, that appeared after the ingestion of shiitake mushrooms, and resolved completely after 2 weeks.

Flagellate dermatitis caused by shiitake mushrooms / Dermatite flagelada após a ingestão de fungos shiitake

Shiitake (Lentinus edodes) is the second most consumed mushroom in the world. It has long been known in Asian medicine for its anticarcinogenic, antihypertensive and serum cholesterol level reduction properties. Nevertheless, the consumption of raw or not well-cooked mushrooms may cause skin eruptions which usually occur 24 to 48 hours after ingestion and are characterized by linearly arranged pruritic erythematous papules and plaques. We present a 36-year-old patient that developed typical symptoms 24 hours after consumption of shiitake mushrooms and summarize therapeutic options and particularities of this disease.

Shiitake (Lentinus edodes) é o segundo tipo de cogumelo mais consumido no mundo. Suas propriedades terapêuticas antitumorais, anti-hipertensivas e redutoras dos níveis elevados de colesterol são há muito conhecidas pela população asiática. Após ingestão desse cogumelo, cru ou malcozido, podem desenvolver-se lesões eritematosas lineares, pruriginosas, que surgem após 24 ou 48 horas em todo o corpo. Apresentamos um paciente de 36 anos com anamnese e clínica típicos, e comentamos as alternativas terapêuticas e nuances dessa dermatose.