香菇皮炎二例

Two cases of shiitake dermatitis

报道2例进食香菇24h后出现典型皮损的病例并总结其特点。例1女，56岁，因突起广泛性皮疹，稍痒就诊。体检：颈部、躯干、肢体见鞭打样条状鲜红色水肿性红斑块，起病前1d吃过香菇，诊断：香菇皮炎。例2男，60岁，躯干、四肢水肿性鞭打样红斑块、丘疹4d。起病2，3d前有食香菇史。取皮损组织病理检查：灶性角化不全，棘细胞内外水肿，真皮乳头高度水肿，纤维间隙明显增宽；真皮浅层毛细血管扩张充血，管周致密的淋巴细胞和少数中性粒细胞浸润。诊断：香菇皮炎。两例均给予泼尼松及抗组胺药物治疗3d和4d，皮疹消退。

Two-patients who developed typical skin eruptions 24 hours after consumption of shiitake mushrooms are reported. Case 1： a 56-year-old woman suddenly developed widespread itching eruptions one day after intake of shiitake mushrooms. On examination, there were erythematous and edematous linear streaks （flagellate erythema ） over the neck, trunk and limbs. Case 2： a 60-year-old man presented with edematous flagellate erythema over the trunk and limbs for four days. He reported intake of shiitake mushroom several days prior to the presentation. Pathological examination revealed focal parakeratosis, intracellular and intercellular edema in the prickle cell layer, severe edema of papillary dermis, evident widening of interfibrous spaces, dilation and congestion of capillaries in the superficial dermis with a mixed perivascular infiltrate of massive lymphocytes and sparse neutrophils. Both patients were diagnosed with shiitake dermatitis, and treated with prednisone and antihistamines. The lesions subsided after 3 and 4 days of treatment in patient 1 and 2 respectively.