title: Clinical features of shiitake dermatitis: a systematic review.
abstract: Shiitake dermatitis is a rare cutaneous reaction to lentinan, a polysaccharide component in the cell walls of shiitake mushrooms (Lentinula edodes). Herein, we systematically review the case report and case series English-language literature on shiitake dermatitis, which refers to a total of 50 patients (38 males, 12 females; mean age: 44.58 years). The majority of cases occurred after the consumption of raw mushrooms, whereas 22% of cases were caused by the eating of lightly or undercooked mushrooms. The most common clinical presentations, localized symptoms, and systemic findings include linear flagellated dermatitis (98%), pruritus (78%), and fever, diarrhea, and mucosal ulcers, respectively. The diagnosis of this entity continues to be based on clinical findings as laboratory abnormalities, and the findings of skin biopsies and patch/prick tests are nonspecific and inconsistent. The condition is self-limiting, resolving in approximately 12.5 d without treatment. Based on the included case reports, it appears that medical treatment may slightly shorten the course of disease (to 9-11 d, varying by therapy) but should be considered on an individual patient basis. However, the treatment of symptoms, reassurance, and the avoidance of re-exposure are sufficient treatment recommendations for this condition.
authors.affiliation: Creighton University School of Medicine, Omaha, NE, USA.
authors.forename: Austin H
authors.initials: AH
authors.lastname: Nguyen
authors.affiliation: Department of Biology, Frank R. Seaver College of Science and Engineering, Loyola Marymount University, Los Angeles, CA, USA.
authors.forename: Maria I
authors.initials: MI
authors.lastname: Gonzaga
authors.affiliation: Creighton University School of Medicine, Omaha, NE, USA.
authors.forename: Victoria M
authors.initials: VM
authors.lastname: Lim
authors.affiliation: Portland Dermatology Clinic, Portland, OR, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Adler
authors.affiliation: Department of Dermatology, Mayo Clinic Florida, Jacksonville, FL, USA.
authors.forename: Mario V
authors.initials: MV
authors.lastname: Mitkov
authors.affiliation: Department of Dermatology, Mayo Clinic Florida, Jacksonville, FL, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Cappel
mesh_terms: D003872:Dermatitis / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007912:Lentinan / Q000506:poisoning; D009145:Mushroom Poisoning / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D020942:Shiitake Mushrooms
chemical_list: D007912:Lentinan