• Jacqueline Mulhall, Anna Elseth, Justin Perdue, Heather Pomerantz, Briana Brown, and Daniel Frasca.
• Departments of General Surgery, Family Medicine, Infectious Disease, and Dermatology at Dwight D. Eisenhower Army Medical Center, Fort Gordon, Georgia.
• J Emerg Med. 2020 Jul 1; 59 (1): e13-e15.

BackgroundShiitake flagellate dermatitis is a shiitake mushroom (SM)-induced toxic dermatosis that is a widely recognized clinical phenomenon in Japan, China, and Korea but is rarely reported outside of Asia. Typically, 24-48 hours after consumption of SM, patients develop severely pruritic, linear, often parallel, infiltrated erythematous lesions, commonly described as being in a "whip-like" pattern. The dermatosis is noted preferentially on the trunk, extremities, and neck. Shiitake flagellate dermatitis is self-limited and typically resolves within days to weeks of its appearance.Case ReportA healthy 36-year-old woman living in the southeastern United States presented with a 48-hour history of pruritic, truncal, morbilliform, flagellate-like efflorescences that extended to her buttocks and thighs. Her hard and soft palates, palms and soles, hair-bearing scalp, and face were also involved. Two days before presentation, the patient ate a store-bought salad preparation that contained raw mushrooms including SMs. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Shiitake dermatitis has a characteristic whip-like pattern that, if identified early by first-line physicians, can relieve concerns for more serious etiologies and expedite appropriate therapy.Published by Elsevier Inc.

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