分别由平菇、黑木耳、金针菇诱发鞭挞样香菇皮炎各一例

Three cases of flagellate shiitake mushroom dermatitis caused by Pleurotus ostreatus,Auricularia auricula and Flammulina velutipes respectively

报道分别由平菇、黑木耳、金针菇诱发鞭挞样香菇皮炎各1例。例1男,45岁,发病前8 h食用大量烧烤平菇,躯干及腋下和腹部出现多条鞭挞样红斑、丘疹,无自觉不适。例2女,33岁,食用凉拌新鲜黑木耳1.5 d后,发现后背多条鞭挞样红斑,轻度肿胀,表面密集分布粟粒大丘疹,自觉轻度瘙痒。例3女,54岁,进食金针菇72 h后,颈部、躯干及四肢近端可见条索状、鞭挞样水肿性红斑、丘疹。例3背部皮损组织病理:表皮海绵水肿,表皮内水疱,真皮乳头水肿,真皮浅层血管扩张,红细胞溢出,扩张的血管周围以淋巴细胞为主的炎性细胞浸润,散在少数嗜酸性粒细胞。诊断:鞭挞样香菇皮炎。例1未处理,例2、例3外用丙酸氟替卡松软膏对症治疗,1周后皮损痊愈。

Three cases of flagellate shiitake mushroom dermatitis caused by Pleurotus ostreatus,Auricularia auricula,and Flammulina velutipes respectively were reported.Case 1,a 45-year-old male patient,developed multiple flagellate erythematous patches and papules on the trunk,axillae and abdomen without any subjective discomfort 8 hours after ingestion of a large amount of grilled Pleurotus ostreatus.Case 2,a 33-year-old female patient,developed multiple flagellate erythematous patches with mild swelling and itching on the back 1.5 days after consuming a fresh Auricularia auricula salad,and millet-sized papules were densely distributed on the erythematous patches.Case 3,a 54-year-old female patient,developed cord-like,flagellate edematous erythema and papules on the neck,trunk and proximal extremities 72 hours after consuming Flammulina velutipes.Histopathological examination of the dorsal lesions in case 3 showed epidermal spongiosis,intraepidermal blisters,papillary dermal edema,superficial dermal vasodilation,erythrocyte extravasation,inflammatory infiltration composed mainly of lymphocytes around dilated blood vessels,and a few scattered eosinophils.The 3 patients were all diagnosed with flagellate shiitake mushroom dermatitis.Case 1 received no treatment,while cases 2 and 3 were symptomatically treated with topical fluticasone propionate ointment,and achieved recovery of skin lesions after 1 week.