Flagellate dermatitis in a patient with testicular germ cell neoplasia on bleomycin

Bleomycin, an antineoplastic antibiotic that inhibits DNA synthesis, is used to treat various malignant tumors such as Hodgkin's lymphoma, squamous cell carcinoma, and germ cell tumors. Flagellate erythema is a rare rash with a linear pattern that has been observed in association with bleomycin treatment. Herein, we present a 43-year-old patient with metastatic testicular cell neoplasms who developed a whiplash rash during treatment with a chemotherapy regimen that included bleomycin. A typical case of bleomycin-related flagellate dermatitis has been diagnosed and the main features of this characteristic adverse drug event are briefly discussed.

Flagellate dermatitis: An atypical skin finding in adult-onset Still's disease

A 23‐year‐old woman followed for adult‐onset Still's disease (AOSD) presented fever and chest pain. Clinical examination showed erythematous papules suggestive of flagellate dermatitis. Laboratory findings showed increased Cardiac troponin. Myocarditis due to AOSD was therefore suspected. The patient was treated with prednisone and methotrexate with significant clinical improvement.

Flagellate Dermatitis After Ingestion of Shiitake Mushrooms in a Healthy Female Living in the Southeastern United States

BACKGROUND

Shiitake flagellate dermatitis is a shiitake mushroom (SM)-induced toxic dermatosis that is a widely recognized clinical phenomenon in Japan, China, and Korea but is rarely reported outside of Asia. Typically, 24-48 hours after consumption of SM, patients develop severely pruritic, linear, often parallel, infiltrated erythematous lesions, commonly described as being in a "whip-like" pattern. The dermatosis is noted preferentially on the trunk, extremities, and neck. Shiitake flagellate dermatitis is self-limited and typically resolves within days to weeks of its appearance.

CASE REPORT

A healthy 36-year-old woman living in the southeastern United States presented with a 48-hour history of pruritic, truncal, morbilliform, flagellate-like efflorescences that extended to her buttocks and thighs. Her hard and soft palates, palms and soles, hair-bearing scalp, and face were also involved. Two days before presentation, the patient ate a store-bought salad preparation that contained raw mushrooms including SMs. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Shiitake dermatitis has a characteristic whip-like pattern that, if identified early by first-line physicians, can relieve concerns for more serious etiologies and expedite appropriate therapy.

Flagellate Pattern of Toxic Erythema of Chemotherapy Due to Doxorubicin: A Case Report

BACKGROUND

Doxorubicin is an antineoplastic agent frequently used in diverse cancer regimens. Cutaneous adverse effects have frequently been reported with its use. However, a flagellate-like dermatitis is not mentioned in the literature.

OBJECTIVE

The investigators report a case of toxic erythema of chemotherapy with a flagellate pattern induced by doxorubicin.

METHODS AND RESULTS

A 75-year-old woman with endometrial cancer received doxorubicin as part of her treatment. After her third cycle, she presented a pruritic vesiculobullous eruption, with linear elements that left hyperpigmented streaks on follow-up. A biopsy was compatible with a drug eruption.

CONCLUSION

Doxorubicin is a well-known cause of toxic erythema of chemotherapy. As seen in this patient, the investigators suggest that it also be added to the list of causes of flagellate dermatosis.

Flagellate dermatitis after consumption of Shiitake mushrooms

Flagellate dermatitis occurs in patients who have eaten Shiitake mushrooms. We are reporting on a 55-year-old man, who developed whiplash-striped, severely itching efflorescences on the trunk 3 days after eating Lentinula edodes. Flagellate dermatitis is also known as a cutaneous side effect of bleomycin therapy.

Flagellate dermatitis following consumption of shiitake mushroom

Japanese dermatologists were the first to describe the very characteristic flagellate dermatitis following consumption of undercooked or raw shiitake mushroom (Lentinus edodes). These similar eruptions were also reported in patients treated with bleomycin, in dermatomyositis and adult onset Still's disease. We report a case where a 40 year old chinese female developed flagellate dermatitis following ingestion of a bun containing shiitake mushroom.