An Itchy, Streaky Back Rash

A 72-year-old man develops an itchy, flagellate rash on his back. What common food item could be the surprising culprit? Explore this case of Dermatitis.

Shiitake mushrooms


A 72-year-old man presented to the emergency department with a 2-day history of an itchy rash on his back. On physical examination, edematous, flagellate plaques and linear patches were present across the patient’s entire back and upper buttocks. There was no adenopathy, dermographism, or mucosal involvement. What substance had the patient most likely handled and ingested before subsequently developing this rash?

What is the most likely diagnosis?

Phenytoin
Shellfish
Shiitake mushrooms
Toxicodendron radicans (poison ivy)
Warfarin

Dermatitis, Flagellate erythema, Pruritus, Shiitake mushrooms, Toxicoderma

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