title: Shiitake dermatitis recorded by French Poison Control Centers - new case series with clinical observations.
abstract: BACKGROUND
  Shiitake (Lentinula edodes) is an edible mushroom which was initially grown in Japan and China and is now sold on the European market. Flagellate erythema may arise following shiitake consumption and was first described in Japan in 1974.
  
  
  OBJECTIVE
  This paper reports a French shiitake dermatitis case series.
  
  
  METHODS
  The findings of retrospective study of shiitake dermatitis cases, reported to French Poison Control Centres (PCC) from January 2000 to December 2013, are reported.
  
  
  RESULTS
  Among 32 exposed patients, 15 presented flagellate urticarial lesions after raw shiitake consumption. The first case of this series was reported in 2006 and the last nine cases were reported as of 2012. After shared meals, no symptoms were reported among guests, who preferred cooked shiitake to the raw mushroom. In this series, rashes appeared 12 h to 5 days (median: 24 h) after raw shiitake ingestion. Linear and itchy urticarial lesions formed on the trunk, arms, and legs within a few hours and persisted for 3-21 days. In four cases, rash and pruritus were either triggered or worsened by sun exposure. Eleven patients received corticosteroids, antihistamines, or both. All patients completely recovered.
  
  
  CONCLUSIONS
  Due to the rapidly increasing consumption of exotic food in Western countries, it is no surprise that cases of shiitake dermatitis are now appearing in Europe. The mechanism of shiitake dermatitis is thought to be toxic and due to lentinan, a polysaccharide component of the mushroom. There is no specific validated treatment for shiitake dermatitis. Health professionals and the general population should be aware of both the risk associated with raw shiitake consumption and of the good prognosis of this very spectacular and uncomfortable toxic dermatitis.
authors.affiliation: Centre Antipoison - Toxicovigilance, CHU Angers , Angers Cedex 9 , France.
authors.forename: D
authors.initials: D
authors.lastname: Boels
authors.forename: A
authors.initials: A
authors.lastname: Landreau
authors.forename: C
authors.initials: C
authors.lastname: Bruneau
authors.forename: R
authors.initials: R
authors.lastname: Garnier
authors.forename: C
authors.initials: C
authors.lastname: Pulce
authors.forename: M
authors.initials: M
authors.lastname: Labadie
authors.forename: L
authors.initials: L
authors.lastname: de Haro
authors.forename: P
authors.initials: P
authors.lastname: Harry
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D003872:Dermatitis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009145:Mushroom Poisoning / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D011039:Poison Control Centers; D012189:Retrospective Studies; D020942:Shiitake Mushrooms; D012867:Skin / Q000473:pathology
keywords: Dermatitis; Lentinula edodes; Mushrooms; Shiitake; Skin