Shiitake Dermatitis: Approach to a Patient with Whiplash Rash

香菇皮膚炎－鞭打狀皮疹之鑑別診斷

余亞倫(Ya-Lun Yu) ； 林家弘(Jia-Hong Lin) ； 蘇昺仰(Bing-Yang Su) ； 葉俊濬(Jun-Jun Yeh) ； 邱健群(Chien-Chun Chiou)

《台灣家庭醫學雜誌》 31卷1期 (2021/03) Pp. 61-66

https://doi.org/10.3966/168232812021033101007

摘要

A 57-year-old man had acute onset, mildly pruritic whiplash-shaped erythematous streaks over his trunk and lower limbs. He ate barbecued shiitake mushroom 3 days prior without other discomfort. Shiitake dermatitis (SD) was clinically diagnosed, and complete resolution was achieved 1 week later through treatment with oral antihistamines. Whiplash-shaped flagellate dermatitis is a unique skin manifestation, which may result from a drug reaction, rheumatic disorder, or undercooked mushrooms. Before diagnosing SD, the clinician must exclude other possible causes through comprehensive history taking and laboratory tests. We developed a flowchart for approaching a patient with whiplash rash.

關鍵字

flagellate dermatitis ； shiitake dermatitis ； whiplash

並列摘要

57歲男性因急性鞭打狀皮疹求診，紅條狀皮膚病灶出現於軀幹與下肢，伴隨輕微的癢感，除此之外沒有其他不適症狀與過往病史。發疹的三天前，曾經食用烤香菇，因此診斷為香菇皮膚炎。只有口服抗組織胺以緩解癢感，鞭打狀皮疹在1週後完全復原。鞭打狀皮疹是一種獨特的皮膚病徵，特定之藥物、風濕疾病、或未充分煮熟的香菇都可能造成此種皮疹表現。針對鞭打狀皮疹的鑑別診斷，筆者歸納整理為一流程圖，有助於在診斷香菇皮膚炎前，藉由詳細的病史詢問，排除特定藥物、接觸物質暴露、以及關節炎和肌肉無力等系統性疾病徵狀。

並列關鍵字

鞭打狀皮疹 ； 香菇皮膚炎

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