{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T15:16:29Z","timestamp":1772118989283,"version":"3.50.1"},"reference-count":16,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>We present the case of a 25-year-old male who attended a dermatological online consultation due to a whiplash-shaped, pruritic rash. The lesions in the form of well-demarcated linear erythematous papules, located mainly on the trunk and arms, had first appeared four days prior to the consultation. Chronic disease history was negative and similar symptoms never appeared previously. After reviewing the clinical images and excluding dermatographism, flagellate dermatitis was suspected. The diagnosis was subsequently confirmed when the patient reported having consumed undercooked shiitake mushrooms two days prior to the onset of the lesions. Topical corticosteroids and oral antihistamines were recommended, and the patient was informed about the necessity of high-temperature preparation of shiitake mushrooms in the future. Flagellate dermatitis is a rare entity speculated to be a hypersensitivity reaction to lentinan, a heat-labile polysaccharide found in shiitake mushrooms (Lentinus edodes). Symptoms include characteristic papular or vesicular lesions erupting in a linear pattern resembling whiplash marks, usually on the trunk and extremities. While the condition is self-limiting, the awareness of its manifestation is important in order to prevent unnecessary biopsies. Patients should be educated to avoid further exposure to lentinan, as instances of severe reactions following repeated contact have been described.<\/jats:p>","DOI":"10.3390\/diagnostics16050692","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T13:58:03Z","timestamp":1772114283000},"page":"692","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Flagellate Dermatitis Induced by Shiitake Mushrooms\u2014Clinical Features of a Rare but Characteristic Entity"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6919-3500","authenticated-orcid":false,"given":"Daniel","family":"Nette","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdansk, Smoluchowskiego 17 Street, 80-214 Gdansk, Poland"},{"name":"Department of Dermatology, Venereology and Allergology, University Clinical Centre in Gdansk, Smoluchowskiego 17 Street, 80-214 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8701-299X","authenticated-orcid":false,"given":"Patrycja","family":"Rogowska","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdansk, Smoluchowskiego 17 Street, 80-214 Gdansk, Poland"},{"name":"Department of Dermatology, Venereology and Allergology, University Clinical Centre in Gdansk, Smoluchowskiego 17 Street, 80-214 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8947-5675","authenticated-orcid":false,"given":"Martyna","family":"S\u0142awi\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdansk, Smoluchowskiego 17 Street, 80-214 Gdansk, Poland"},{"name":"Department of Dermatology, Venereology and Allergology, University Clinical Centre in Gdansk, Smoluchowskiego 17 Street, 80-214 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"129883","DOI":"10.1016\/j.foodchem.2021.129883","article-title":"Recent advances in polysaccharides from Lentinus edodes (Berk.): Isolation, structures and bioactivities","volume":"358","author":"Sheng","year":"2021","journal-title":"Food Chem."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1093\/skinhd\/vzae012","article-title":"An unusually severe case of shiitake mushroom dermatitis with features of drug reaction with eosinophilia and systemic symptoms","volume":"5","author":"Ng","year":"2025","journal-title":"Ski. Health Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1684\/ejd.2020.3777","article-title":"Shiitake dermatitis: A type IV allergic hypersensitivity reaction to raw mushrooms","volume":"30","author":"Albuscheit","year":"2020","journal-title":"Eur. J. Dermatol."},{"key":"ref_4","first-page":"e55437","article-title":"Recognizing Flagellate Erythema in Skin of Color: A Case of Shiitake Dermatitis","volume":"16","author":"Gofman","year":"2024","journal-title":"Cureus"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e278","DOI":"10.1111\/ijd.16647","article-title":"Shiitake dermatitis: Clinical forms of presentation","volume":"62","author":"Sudy","year":"2023","journal-title":"Int. J. Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1159\/000018007","article-title":"Flagellate mushroom (Shiitake) dermatitis and photosensitivity","volume":"197","author":"Hanada","year":"1998","journal-title":"Dermatology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1111\/ced.12500","article-title":"Shiitake dermatitis with oral ulceration and pustules","volume":"40","author":"Hamer","year":"2015","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1590\/abd1806-4841.20153396","article-title":"Shiitake dermatitis","volume":"90","author":"Silva","year":"2015","journal-title":"An. Bras. Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1111\/ijd.13433","article-title":"Clinical features of shiitake dermatitis: A systematic review","volume":"56","author":"Nguyen","year":"2017","journal-title":"Int. J. Dermatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e179","DOI":"10.1111\/ijd.12361","article-title":"Shiitake dermatitis demonstrating K\u00f6ebner phenomenon","volume":"54","author":"Ade","year":"2015","journal-title":"Int. J. Dermatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"625","DOI":"10.3109\/15563650.2014.923905","article-title":"Shiitake dermatitis recorded by French Poison Control Centers\u2014New case series with clinical observations","volume":"52","author":"Boels","year":"2014","journal-title":"Clin. Toxicol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e232785","DOI":"10.1136\/bcr-2019-232785","article-title":"Severe flagellate erythema in idiopathic dermatomyositis","volume":"12","author":"Mai","year":"2019","journal-title":"BMJ Case Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.jdcr.2025.10.024","article-title":"Flagellate erythema-like persistent eruption of Still\u2019s disease treated with a Janus kinase inhibitor","volume":"67","author":"Kassels","year":"2025","journal-title":"JAAD Case Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.clindermatol.2019.10.006","article-title":"Drug eruptions associated with tumor therapy: Great imitators","volume":"38","author":"Ludwig","year":"2020","journal-title":"Clin. Dermatol."},{"key":"ref_15","first-page":"e92","article-title":"A closer look at chemotherapy-induced flagellate dermatitis","volume":"2","author":"Constantinou","year":"2022","journal-title":"Ski. Health Dis."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Moschella, A., and Kirchhof, M.G. (2025). Trends in Shiitake Mushroom-Induced Dermatitis: A Systematic Review of Reported Cases over Time. J. Cutan. Med. 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