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The New England Journal of MedicineImages in Clinical Medicine: Shiitake Dermatitis

A 72-year-old man experienced a severe itchy rash after consuming a meal containing shiitake mushrooms. This case highlights the importance of dietary history in diagnosing skin conditions and the potential effects of certain foods on the body.

HCN Medical Memo
This case underscores the importance of considering dietary history in the diagnosis of skin conditions. Healthcare professionals should be aware of the potential for certain foods, such as raw or undercooked shiitake mushrooms, to cause adverse reactions. This knowledge can guide treatment decisions and patient advice.

Key Points

  • The patient presented with an itchy rash on his back, which had impaired his sleep.
  • The rash appeared two days after he had eaten a meal containing shiitake mushrooms.
  • Physical examination revealed edematous, flagellate plaques and linear patches across his back and upper buttocks.
  • The diagnosis was shiitake dermatitis, a condition that occurs after consumption of raw or undercooked shiitake mushrooms.
  • The patient was advised to fully cook shiitake mushrooms in the future and was given topical glucocorticoids and oral antihistamines for symptom treatment.

“Let food be thy medicine and medicine be thy food.”
– Hippocrates

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