Case and research letters
Flagellate Dermatitis After Eating Shiitake Mushrooms
Dermatitis flagelada tras la ingesta de setas del género Shiitake
T. Díaz-Corpas
, A. Mateu-Puchades, M.N. Coll-Puigserver, A. Marquina-Vila
Corresponding author
Servicio de Dermatología, Hospital Universitario Dr. Peset, Valencia, Spain
Read
16920
Timeswas read the article
4021
Total PDF
12899
Total HTML
Share statistics
array:24 [ "pii" => "S1578219012000248" "issn" => "15782190" "doi" => "10.1016/j.adengl.2012.01.010" "estado" => "S300" "fechaPublicacion" => "2011-12-01" "aid" => "433" "copyright" => "Elsevier España, S.L. and AEDV" "copyrightAnyo" => "2010" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2011;102:830-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 7141 "formatos" => array:3 [ "EPUB" => 52 "HTML" => 5621 "PDF" => 1468 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731011002900" "issn" => "00017310" "doi" => "10.1016/j.ad.2011.03.023" "estado" => "S300" "fechaPublicacion" => "2011-12-01" "aid" => "433" "copyright" => "Elsevier España, S.L. y AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2011;102:830-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 8933 "formatos" => array:3 [ "EPUB" => 5 "HTML" => 6809 "PDF" => 2119 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científico clínicas</span>" "titulo" => "Dermatitis flagelada tras la ingesta de setas del género Shiitake" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "830" "paginaFinal" => "832" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Flagellate Dermatitis After Eating Shiitake Mushrooms" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figura 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 713 "Ancho" => 950 "Tamanyo" => 148867 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">«Scratch-test» positivo a las 96 horas con vesiculación. En esquina inferior derecha setas del género Shiitake que aportó la paciente.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "T. Díaz-Corpas, A. Mateu-Puchades, M.N. Coll-Puigserver, A. Marquina-Vila" "autores" => array:4 [ 0 => array:2 [ "nombre" => "T." "apellidos" => "Díaz-Corpas" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Mateu-Puchades" ] 2 => array:2 [ "nombre" => "M.N." "apellidos" => "Coll-Puigserver" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Marquina-Vila" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219012000248" "doi" => "10.1016/j.adengl.2012.01.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012000248?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731011002900?idApp=UINPBA000044" "url" => "/00017310/0000010200000010/v1_201304241344/S0001731011002900/v1_201304241344/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219012000261" "issn" => "15782190" "doi" => "10.1016/j.adengl.2011.03.015" "estado" => "S300" "fechaPublicacion" => "2011-12-01" "aid" => "435" "copyright" => "Elsevier España, S.L. and AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2011;102:832-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5147 "formatos" => array:3 [ "EPUB" => 51 "HTML" => 3445 "PDF" => 1651 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Comment on: Nonsexually Transmitted Acute Ulcer of the Vulva Associated With Influenza A Virus Infection" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "832" "paginaFinal" => "833" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Úlcera vulvar aguda de transmisión no sexual asociada a infección por virus influenza A" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "I. López-Lerma, M. Serra-Torres, V. García-Patos Briones" "autores" => array:3 [ 0 => array:2 [ "nombre" => "I." "apellidos" => "López-Lerma" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Serra-Torres" ] 2 => array:2 [ "nombre" => "V." "apellidos" => "García-Patos Briones" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731011003103" "doi" => "10.1016/j.ad.2011.03.025" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731011003103?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012000261?idApp=UINPBA000044" "url" => "/15782190/0000010200000010/v1_201304241244/S1578219012000261/v1_201304241244/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219012000236" "issn" => "15782190" "doi" => "10.1016/j.adengl.2012.01.009" "estado" => "S300" "fechaPublicacion" => "2011-12-01" "aid" => "431" "copyright" => "Elsevier España, S.L. and AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2011;102:828-30" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4420 "formatos" => array:3 [ "EPUB" => 51 "HTML" => 3613 "PDF" => 756 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and research letters</span>" "titulo" => "Episode of Pustular Psoriasis After a Tuberculin Test in a Patient With Plaque Psoriasis on Treatment With Etanercept" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "828" "paginaFinal" => "830" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Brote de psoriasis pustulosa después de la prueba de la tuberculina en un paciente con psoriasis en placas en tratamiento con etanercept" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1182 "Ancho" => 1580 "Tamanyo" => 248714 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pustules on the residual psoriasis plaques.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R.M. Guinovart, C. Ferrándiz, I. Bielsa, J.M. Carrascosa" "autores" => array:4 [ 0 => array:2 [ "nombre" => "R.M." "apellidos" => "Guinovart" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Ferrándiz" ] 2 => array:2 [ "nombre" => "I." "apellidos" => "Bielsa" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "Carrascosa" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731011002882" "doi" => "10.1016/j.ad.2011.04.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731011002882?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012000236?idApp=UINPBA000044" "url" => "/15782190/0000010200000010/v1_201304241244/S1578219012000236/v1_201304241244/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and research letters</span>" "titulo" => "Flagellate Dermatitis After Eating Shiitake Mushrooms" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the editor:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "830" "paginaFinal" => "832" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "T. Díaz-Corpas, A. Mateu-Puchades, M.N. Coll-Puigserver, A. Marquina-Vila" "autores" => array:4 [ 0 => array:4 [ "nombre" => "T." "apellidos" => "Díaz-Corpas" "email" => array:1 [ 0 => "ainatdc@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Mateu-Puchades" ] 2 => array:2 [ "nombre" => "M.N." "apellidos" => "Coll-Puigserver" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Marquina-Vila" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Dermatología, Hospital Universitario Dr. Peset, Valencia, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Dermatitis flagelada tras la ingesta de setas del género Shiitake" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2000 "Ancho" => 1500 "Tamanyo" => 395154 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Crisscrossing linear erythematous lesions, primarily on the trunk.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The shiitake mushroom (<span class="elsevierStyleItalic">Lentinus edodes</span>), commonly eaten in China and Japan, is the second most widely consumed mushroom species worldwide and it is also becoming increasingly available in Western markets.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> In Japan, the shiitake mushroom is used as an antihypertensive or lipid-lowering agent and as adjuvant therapy against colorectal or gastric cancer because of the beneficial properties of its polysaccharide lentinan.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Flagellate dermatitis caused by the consumption of undercooked or raw shiitake mushrooms usually occurs 48-72<span class="elsevierStyleHsp" style=""></span>hours after ingestion. It presents as papular, petechial, or vesicular lesions in a crisscrossed, linear pattern, primarily on the trunk, upper limbs, neck, and face, accompanied by marked pruritus.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Several authors have reported other adverse reactions to shiitake mushrooms, including allergic contact dermatitis, phototoxicity, contact urticaria, allergic asthma, and isolated cases of chronic hypersensitivity pneumonitis induced by shiitake spores.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5–7</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">We present the case of a 79-year-old woman who visited our unit for an emergency examination of a very itchy rash 72<span class="elsevierStyleHsp" style=""></span>hours after onset. The only relevant medical history was that the patient was being monitored for chronic cutaneous lupus. The lesions had not responded to an intramuscular corticosteroid injection administered 24<span class="elsevierStyleHsp" style=""></span>hours earlier.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The patient reported eating grilled mushrooms 72<span class="elsevierStyleHsp" style=""></span>hours prior to the appearance of the lesions. She had not taken any medication prior to the onset of the cutaneous symptoms, and presented no fever, joint pain, or other systemic symptoms.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Physical examination revealed multiple crisscrossing linear erythematous lesions composed of petechiae that did not blanch with pressure. The lesions were located primarily on the trunk, neckline, and proximal areas of the upper and lower limbs (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). There was no mucosal involvement.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Laboratory tests were normal, and a biopsy of one of the lesions revealed spongiotic dermatitis and slight blood extravasation in the superficial dermis.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The patient returned for a follow-up visit 2 weeks later, by which time the lesions had completely resolved (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). She provided a sample of the mushrooms she had ingested prior to the appearance of the lesions. They belonged to the shiitake species (<span class="elsevierStyleItalic">L. edodes</span>), though it was unclear whether they had been imported (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). The mushrooms were refrigerated and later used to carry out, in the patient and 10 healthy controls, Finn Chamber epicutaneous patch tests and scratch tests in which a Microlance 3 needle (0.5 x 16<span class="elsevierStyleHsp" style=""></span>mm) was used to prepare the surface of the skin without causing bleeding. The results were read 2, 48 and 72<span class="elsevierStyleHsp" style=""></span>hours after test administration. The patient's scratch test was positive at 48 and 96<span class="elsevierStyleHsp" style=""></span>hours, when it displayed marked erythema and vesiculation (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>), but her patch tests were negative. None of the controls had positive reactions in either hypersensitivity test.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Shiitake dermatitis was first described in a series of 23 cases published in 1977 by Nakamura,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> who went on to publish a longer series in 1992.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> To date, approximately 100 cases have been reported worldwide, mostly in China and Japan, only a few in Europe,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> and none in Spain.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Shiitake dermatitis appears in certain people following consumption of undercooked or raw shiitake mushrooms; this suggests that these individuals must be susceptible or hypersensitive to a thermolabile substance present in the mushroom.</p><p id="par0055" class="elsevierStylePara elsevierViewall">As biopsy results usually indicate nonspecific spongiotic dermatitis,<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> shiitake dermatitis is diagnosed on the basis of the appropriate clinical signs and symptoms in a patient who has eaten undercooked or raw shiitake mushrooms.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–4,8</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">It has a clinical picture similar to that of the flagellate dermatitis induced by drugs such as bleomycin,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> although the mechanism of action does not appear to be the same.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> While lentinan, the polysaccharide found in shiitake mushrooms, is thought to be responsible for the lesions of flagellate dermatitis<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–4,8</span></a> due to the production of IL-1, the exact pathogenesis is poorly understood.</p><p id="par0065" class="elsevierStylePara elsevierViewall">The negative patch test results cast doubt on the hypersensitivity hypothesis. However, the results of scratch and prick-to-prick test vary, and in some cases, like that of our patient, these tests have been positive.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> We therefore posit that the symptoms described were the result of a systemic allergic reaction to the shiitake mushroom.</p><p id="par0070" class="elsevierStylePara elsevierViewall">This is the first case of shiitake dermatitis to be reported in Spain, and it yielded a positive scratch test result. We believe that this case supports the hypothesis that this dermatitis is caused by a delayed hypersensitivity reaction and that cutaneous hypersensitivity tests could therefore be useful tools for diagnosing the condition and determining its exact pathogenesis, which remains unclear.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Díaz-Corpas T, et al. Dermatitis flagelada tras la ingesta de setas del género Shiitake. Actas Dermosifiliogr. 2011;102:830-832.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2000 "Ancho" => 1500 "Tamanyo" => 395154 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Crisscrossing linear erythematous lesions, primarily on the trunk.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1750 "Ancho" => 2337 "Tamanyo" => 302466 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Complete resolution of the lesions after 2 weeks.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1183 "Ancho" => 1585 "Tamanyo" => 180411 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Positive scratch test with vesiculation after 96<span class="elsevierStyleHsp" style=""></span>hours. Inset, bottom right: shiitake mushrooms provided by the patient.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Toxicoderma caused by shiitake (<span class="elsevierStyleItalic">Lentinus edodes</span>)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "T. Nakamura" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Jpn J Clin Dermatol" "fecha" => "1977" "volumen" => "31" "paginaInicial" => "65" "paginaFinal" => "68" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Shiitake (<span class="elsevierStyleItalic">Lentinus edodes</span>) dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "T. Nakamura" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Contact Dermatitis" "fecha" => "1992" "volumen" => "27" "paginaInicial" => "65" "paginaFinal" => "70" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1395630" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Shiitake dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "U. Lippert" 1 => "V. Martin" 2 => "C. Schwertfeger" 3 => "V. Junghans" 4 => "B. Ellinghaus" 5 => "T. Fuchs" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2003" "volumen" => "148" "paginaInicial" => "178" "paginaFinal" => "179" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12534625" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0886335011001179" "estado" => "S300" "issn" => "08863350" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Shiitake dermatitis diagnosed after 16 years!" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Garg" 1 => "S.E. Cockayne" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archderm.144.9.1241" "Revista" => array:7 [ "tituloSerie" => "Arch Dermatol" "fecha" => "2008" "volumen" => "144" "paginaInicial" => "1241" "paginaFinal" => "1242" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18794485" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0002939411003710" "estado" => "S300" "issn" => "00029394" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Occupational protein contact dermatitis from shiitake mushroom and demonstration of shiitake-specific immunoglobulin E" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K. Aalto-Korte" 1 => "P. Susitaival" 2 => "R. Kaminska" 3 => "S. Mäkinen-Kiljunen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.0105-1873.2005.00613.x" "Revista" => array:6 [ "tituloSerie" => "Contact Dermatitis" "fecha" => "2005" "volumen" => "53" "paginaInicial" => "211" "paginaFinal" => "213" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16191017" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Allergic contact dermatitis in shiitake (Lentinus edades (Berk) Sing) growers" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Ueda" 1 => "K. Obama" 2 => "K. Aoyama" 3 => "T. Ueda" 4 => "B.H. Xu" 5 => "Q. Li" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Contact dermatitis" "fecha" => "1992" "volumen" => "26" "paginaInicial" => "228" "paginaFinal" => "233" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1395559" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Respiratory and immunological reactions among Shiitale (Lentinus edodes) mushroom workers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Sastre" 1 => "M.D. Ibáñez" 2 => "M. López" 3 => "S.B. Lehrer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Exp Allergy" "fecha" => "1990" "volumen" => "20" "paginaInicial" => "13" "paginaFinal" => "19" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1967128" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Shiitake dermatitis: the first case reported from European country" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.K. Mak" 1 => "S.H. Wakelin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2133.2006.07174.x" "Revista" => array:7 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2006" "volumen" => "154" "paginaInicial" => "800" "paginaFinal" => "801" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16536844" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0002939411003722" "estado" => "S300" "issn" => "00029394" ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Toxicidad cutánea inducida por el tratamiento con bleomicina" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.M. Martín-Hernández" 1 => "M.I. Pinazo" 2 => "E. Montesinos" 3 => "R. Sánchez-Castaño" 4 => "E. Jordá" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2003" "volumen" => "94" "paginaInicial" => "493" "paginaFinal" => "494" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Systemic allergic contact dermatitis due to consumption of raw shiitake mushroom" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T. Kopp" 1 => "P. Mastan" 2 => "N. Mothes" 3 => "S. Tzaneva" 4 => "G. Stingl" 5 => "A. Tanew" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2230.2009.03297.x" "Revista" => array:7 [ "tituloSerie" => "Clin Exp Dermatol" "fecha" => "2009" "volumen" => "34" "paginaInicial" => "910" "paginaFinal" => "913" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19456762" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0002939411000481" "estado" => "S300" "issn" => "00029394" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010200000010/v1_201304241244/S1578219012000248/v1_201304241244/en/main.assets" "Apartado" => array:4 [ "identificador" => "6157" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010200000010/v1_201304241244/S1578219012000248/v1_201304241244/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012000248?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 40 | 11 | 51 |
| 2024 October | 220 | 62 | 282 |
| 2024 September | 279 | 68 | 347 |
| 2024 August | 284 | 82 | 366 |
| 2024 July | 248 | 55 | 303 |
| 2024 June | 228 | 79 | 307 |
| 2024 May | 270 | 88 | 358 |
| 2024 April | 188 | 35 | 223 |
| 2024 March | 238 | 47 | 285 |
| 2024 February | 237 | 47 | 284 |
| 2024 January | 187 | 57 | 244 |
| 2023 December | 205 | 54 | 259 |
| 2023 November | 173 | 47 | 220 |
| 2023 October | 183 | 63 | 246 |
| 2023 September | 117 | 39 | 156 |
| 2023 August | 91 | 50 | 141 |
| 2023 July | 136 | 46 | 182 |
| 2023 June | 164 | 29 | 193 |
| 2023 May | 164 | 79 | 243 |
| 2023 April | 136 | 33 | 169 |
| 2023 March | 177 | 51 | 228 |
| 2023 February | 172 | 33 | 205 |
| 2023 January | 134 | 39 | 173 |
| 2022 December | 117 | 48 | 165 |
| 2022 November | 89 | 38 | 127 |
| 2022 October | 69 | 19 | 88 |
| 2022 September | 82 | 39 | 121 |
| 2022 August | 56 | 39 | 95 |
| 2022 July | 49 | 41 | 90 |
| 2022 June | 56 | 32 | 88 |
| 2022 May | 106 | 42 | 148 |
| 2022 April | 124 | 47 | 171 |
| 2022 March | 91 | 72 | 163 |
| 2022 February | 110 | 39 | 149 |
| 2022 January | 127 | 53 | 180 |
| 2021 December | 90 | 55 | 145 |
| 2021 November | 110 | 49 | 159 |
| 2021 October | 94 | 56 | 150 |
| 2021 September | 92 | 49 | 141 |
| 2021 August | 80 | 44 | 124 |
| 2021 July | 64 | 40 | 104 |
| 2021 June | 85 | 48 | 133 |
| 2021 May | 86 | 54 | 140 |
| 2021 April | 255 | 84 | 339 |
| 2021 March | 165 | 41 | 206 |
| 2021 February | 145 | 39 | 184 |
| 2021 January | 91 | 30 | 121 |
| 2020 December | 101 | 20 | 121 |
| 2020 November | 87 | 30 | 117 |
| 2020 October | 54 | 24 | 78 |
| 2020 September | 71 | 26 | 97 |
| 2020 August | 40 | 23 | 63 |
| 2020 July | 46 | 21 | 67 |
| 2020 June | 59 | 44 | 103 |
| 2020 May | 54 | 35 | 89 |
| 2020 April | 32 | 19 | 51 |
| 2020 March | 28 | 19 | 47 |
| 2020 February | 3 | 0 | 3 |
| 2020 January | 4 | 5 | 9 |
| 2019 December | 6 | 2 | 8 |
| 2019 November | 4 | 0 | 4 |
| 2019 August | 6 | 0 | 6 |
| 2019 July | 4 | 0 | 4 |
| 2019 June | 4 | 6 | 10 |
| 2019 May | 4 | 31 | 35 |
| 2019 April | 2 | 7 | 9 |
| 2019 March | 2 | 12 | 14 |
| 2019 January | 2 | 0 | 2 |
| 2018 December | 4 | 0 | 4 |
| 2018 November | 3 | 0 | 3 |
| 2018 October | 3 | 0 | 3 |
| 2018 September | 1 | 0 | 1 |
| 2018 June | 1 | 1 | 2 |
| 2018 May | 0 | 4 | 4 |
| 2018 April | 0 | 2 | 2 |
| 2018 March | 9 | 1 | 10 |
| 2018 February | 140 | 10 | 150 |
| 2018 January | 158 | 21 | 179 |
| 2017 December | 155 | 15 | 170 |
| 2017 November | 137 | 17 | 154 |
| 2017 October | 142 | 15 | 157 |
| 2017 September | 132 | 31 | 163 |
| 2017 August | 126 | 30 | 156 |
| 2017 July | 137 | 28 | 165 |
| 2017 June | 150 | 40 | 190 |
| 2017 May | 120 | 49 | 169 |
| 2017 April | 156 | 28 | 184 |
| 2017 March | 97 | 29 | 126 |
| 2017 February | 61 | 32 | 93 |
| 2017 January | 107 | 26 | 133 |
| 2016 December | 174 | 12 | 186 |
| 2016 November | 245 | 21 | 266 |
| 2016 October | 284 | 19 | 303 |
| 2016 September | 392 | 20 | 412 |
| 2016 August | 376 | 27 | 403 |
| 2016 July | 173 | 19 | 192 |
| 2016 June | 13 | 17 | 30 |
| 2016 May | 6 | 17 | 23 |
| 2016 April | 5 | 2 | 7 |
| 2016 March | 10 | 13 | 23 |
| 2016 February | 5 | 1 | 6 |
| 2016 January | 7 | 12 | 19 |
| 2015 December | 9 | 6 | 15 |
| 2015 November | 10 | 1 | 11 |
| 2015 October | 9 | 7 | 16 |
| 2015 September | 3 | 2 | 5 |
| 2015 August | 14 | 2 | 16 |
| 2015 July | 144 | 16 | 160 |
| 2015 June | 72 | 6 | 78 |
| 2015 May | 109 | 24 | 133 |
| 2015 April | 84 | 17 | 101 |
| 2015 March | 74 | 16 | 90 |
| 2015 February | 67 | 19 | 86 |
| 2015 January | 79 | 20 | 99 |
| 2014 December | 75 | 18 | 93 |
| 2014 November | 64 | 17 | 81 |
| 2014 October | 74 | 24 | 98 |
| 2014 September | 55 | 22 | 77 |
| 2014 August | 80 | 19 | 99 |
| 2014 July | 90 | 22 | 112 |
| 2014 June | 110 | 13 | 123 |
| 2014 May | 106 | 19 | 125 |
| 2014 April | 89 | 15 | 104 |
| 2014 March | 100 | 65 | 165 |
| 2014 February | 84 | 51 | 135 |
| 2014 January | 80 | 56 | 136 |
| 2013 December | 82 | 36 | 118 |
| 2013 November | 29 | 45 | 74 |
| 2013 October | 19 | 30 | 49 |
| 2013 September | 13 | 27 | 40 |
| 2013 August | 16 | 25 | 41 |
| 2013 July | 15 | 50 | 65 |
| 2013 June | 14 | 37 | 51 |
| 2013 May | 17 | 28 | 45 |
| 2013 April | 15 | 29 | 44 |
| 2013 March | 12 | 23 | 35 |
| 2013 February | 46 | 14 | 60 |
| 2013 January | 60 | 11 | 71 |
| 2012 December | 33 | 11 | 44 |
| 2012 November | 0 | 1 | 1 |
| 2012 October | 0 | 2 | 2 |
| 2012 July | 1 | 0 | 1 |
Show all
