Shiitake mushrooms play a significant role in East Asian culture as a widely used culinary ingredient. With the increasing popularity of Japanese food in the UK, they are now widely available in British supermarkets. Little known, however, is the risk of a reaction from consuming raw or undercooked shiitake mushrooms, which manifests as a cutaneous eruption about 2 days after ingestion. While this reaction is well-recognised in East Asia, there is a need for UK GPs to be aware of this reaction and know how to manage it. A 62-year-old male presented with a 3-day history of paraesthesia of the hands, which evolved into an intensely pruritic, erythematous linear eruption on the trunk and limbs (Figures 1 and 2). In addition, he exhibited a coalescing papular rash on the dorsum of his hands. There was no mucosal involvement.
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