Rare occurrence of shiitake dermatitis in Indonesia: A case report
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Abstract. Adji A, Tan S, Warouw M, Liong GK, Walid FR, Christopher PM. 2024. Rare occurrence of shiitake dermatitis in Indonesia: A case report. Biodiversitas 25: 4790-4795. The present study identified shiitake dermatitis as a unique dermatological manifestation of undercooked shiitake mushrooms. However, this discovery has not yet been reported in Indonesia. Shiitake mushrooms contain lentinan, a natural polysaccharide ?-D-glucan polymer. Lentinan is considered a pathogen-associated molecular pattern that may trigger both innate and adaptive immunological responses by binding on pattern recognition receptors on immune cells. The binding of lentinan to its receptors activates many signaling pathways, eliciting an enhanced innate immune response, which may manifest as shiitake dermatitis. A 48-year-old Caucasian man of German nationality presented with a 3-day history of an extensive, minimally pruritic skin eruption of linear groups of erythematous papules in a flagellate pattern on both sides of the abdomen and mainly on his back. The patient denied any previous history of scratching, exposure to new/routine medications, supplements, topical products, animals, plants, recent travel, or outdoor activities. Additionally, constitutional symptoms were denied. Based on the clinical results and the exclusion of differential diagnoses, a diagnosis of shiitake dermatitis was established. The patient was prescribed symptomatic treatment consisting of oral and topical corticosteroids and an oral antihistamine, which yielded a significant improvement in response. This is the first case of shiitake dermatitis to be reported in Indonesia.
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