香菇皮膚炎-- 鞭打狀皮疹之鑑別診斷
 
余亞倫¹　林家弘¹　蘇昺仰¹　葉俊濬¹　邱健群²

 
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。
（台灣家醫誌2021; 31: 61-66）DOI: 10.3966/168232812021033101007
 
關鍵詞：鞭打狀皮疹、香菇皮膚炎
 

---

¹戴德森醫療財團法人嘉義基督教醫院家庭醫學科、²皮膚科
受理日期：109年2月7日　　修改日期：109年6月3日　　同意刊登：109年9月1日

---

---

 

Shiitake Dermatitis: Approach to a Patient with Whiplash Rash
 
Ya-Lun Yu¹, Jia-Hong Lin¹, Bing-Yang Su¹, Jun-Jun Yeh¹ and Chien-Chun Chiou²

 
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.
(Taiwan J Fam Med 2021; 31: 61-66) DOI: 10.3966/168232812021033101007
 
Key words: flagellate dermatitis, shiitake dermatitis, whiplash
 

---

¹Departments of Family Medicine and ²Dermatology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Taiwan. Correspondence to: Ya-Lun Yu & Chien-Chun Chiou, Ditmanson Medical Foundation Chia-Yi Christian Hospital. E-mail:yuyalun@gmail.com
Received: February 7, 2020; Revised: June 3, 2020; Accpted: September 1, 2020.