Public Health Department - SPIn Unit, Nantes University Hospital, France and Inserm UMRS 1144, University of Paris, Paris, France.
ANSES - French Agency for Food, Environmental and Occupational Health and Safety, Maisons-Alfort, France.
Clin Toxicol (Phila). 2022 Aug;60(8):954-959. doi: 10.1080/15563650.2022.2059496. Epub 2022 Apr 11.
Shiitake mushrooms () are an edible fungus, initially grown in Japan and China that are increasingly marketed in Europe. We previously presented 15 shiitake dermatitis cases reported to Poison Control Centres (PCCs) in France from January 2000 to December 2013. The aim of this study was to describe changes in the number of shiitake dermatitis cases since 2014, and to better describe the clinical characteristics and risk factors of this reaction.
This observational study is a retrospective review of cases in the French PCCs database between 1 January 2014 and 31 December 2019. Out of 125 shiitake exposures, we identified 59 cases of dermatitis: sex ratio of 1.80 M/F; ages ranging from 19 to 69 years (median: 39 years). Dermatitis occurred after raw or undercooked shiitake consumption (e.g., from the wok, in soup, or on pizza). The rash appeared 1-168 h (median: 48 h) after shiitake ingestion. Linear, erythematous, urticarial papules and plaques developed across the trunk, arms, and legs within a few hours and persisted for 1-40 d (median 10 d). The amount of shiitake eaten (low medium high) significantly increased the duration of dermatitis (median days 4 7 15, respectively; = .007). In all, 38 patients received corticosteroids, antihistamine drugs, or both without demonstrated benefit. All patients made a complete recovery.
The mechanism of shiitake dermatitis is thought to involve lentinan, a heat-labile polysaccharide component. Inadequate cooking clearly seems to be a driver of the occurrence of shiitake dermatitis. This study highlighted a dose-dependent response, suggesting a partial toxic mechanism or a th1-type hypersensitivity mechanism. Treatment is focused on symptom management. Health professionals and the general population should be aware of both the risk associated with inadequately cooked shiitake consumption and the favourable prognosis of this still poorly known toxic dermatitis.
香菇（）是一种可食用的真菌，最初生长在日本和中国，在欧洲的市场份额越来越大。我们之前曾报告过法国毒物控制中心（PCC）自 2000 年 1 月至 2013 年 12 月期间报告的 15 例香菇性皮炎病例。本研究的目的是描述 2014 年以来香菇性皮炎病例数量的变化，并更好地描述这种反应的临床特征和危险因素。
本观察性研究回顾了 2014 年 1 月 1 日至 2019 年 12 月 31 日期间法国 PCC 数据库中的病例。在 125 例香菇暴露中，我们确定了 59 例皮炎病例：男女比例为 1.80:1；年龄 19-69 岁（中位数：39 岁）。皮炎发生于食用生的或未煮熟的香菇后（例如，来自炒菜锅、汤中或比萨饼上）。皮疹在食用香菇后 1-168 小时（中位数：48 小时）出现。线性、红斑、荨麻疹样丘疹和斑块在数小时内出现在躯干、手臂和腿部，并持续 1-40 天（中位数 10 天）。食用香菇的量（低、中、高）显著延长了皮炎的持续时间（中位数天数分别为 4、7、15 天；= 0.007）。共有 38 名患者接受了皮质类固醇、抗组胺药物或两者联合治疗，但无明显疗效。所有患者均完全康复。
香菇性皮炎的发病机制被认为涉及香菇多糖，一种不耐热的多糖成分。显然，烹饪不当似乎是香菇性皮炎发生的一个驱动因素。本研究强调了一种剂量依赖性反应，提示存在部分毒性机制或 th1 型超敏反应机制。治疗的重点是症状管理。卫生专业人员和公众都应该意识到食用未充分烹饪的香菇的风险以及这种尚未被充分认识的毒性皮炎的良好预后。
