The patient was a previously healthy 23-year-old Caucasian male who complained of the sudden onset of linear rash on his trunk evolving for 2 days. The patient denied other symptoms, such as pruritus, arthralgia, mucosal abnormalities, and fever. When asked about consumption of shiitake, he confirmed that he had eaten those mushrooms 4 days before he sought medical assistance and stated that he thought the shiitakes had been well cooked. The patient denied the intake of other medications or changes of personal hygiene products.\nAt physical examination, the patient presented with small, grouped papules forming a linear design, spreading on the trunk and extending to the proximal part of the upper limbs (Fig. , , ). No alterations on the face, scalp, or mucosa were observed. Dexamethasone ointment was applied for 5 days in the area of the lesions, and complete remission was observed after 7 days.
Male patient, 30 years old, white, born and living in Rio de Janeiro, RJ, Brazil,\ncomplained of intense pruritus followed by disseminated erythematous lesions with onset\nless than 24 hours before. He had no history of associated diseases, use of any\nmedications or any other associated factors. On the first inspection we noted small\nerythematous papules and some petechiae that assumed a linear pattern located on the\ntrunk, lower and upper limbs. There were no mucosal abnormalities, fever or any other\nsystemic symptoms ( and ). Based on the peculiar rash, the patient was\nquestioned about the ingestion of shiitake and confirmed he had eaten a\nlarge amount of raw mushrooms five hours before the cutaneous lesions appeared, leading\nus to the diagnosis of flagellate erythema due to shiitake\ningestion.