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Cutaneous manifestations in patients suspected of chikungunya disease.

Prashant S, Kumar AS, Basheeruddin DD, Chowdhary TN, Madhu B - Indian J Dermatol (2009)

Bottom Line: Genital ulcers distributed predominantly over the scrotum and base of the penile shaft in men and labia majora in women were the second most common manifestation.Other manifestations included tenderness/edema of hands and feet, grouped hyperpigmented macules over the nose and cheeks, fixed drug eruptions, erythema nodosum, erythema multiformae, generalized urticarial eruptions, and flare up of pre-existing psoriasis and lichen planus.Genital ulcers, to the best of our knowledge, have not been reported during the earlier epidemics but have been reported by others during the present one.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology and Venereology, Deccan College of Medical Sciences and Allied Institutes i.e., OwaisiHospital and Princess Esra Hospital, India. prashantsoma@yahoo.com

ABSTRACT

Context: An epidemic of chikungunya disease occurred in India during late 2005 through 2006 affecting nearly 1,400,000 people.

Aim: To study the cutaneous manifestations in suspected cases of chikungunya disease.

Settings and design: Patients who attended our outpatient departments from January 2006 to September 2006 were prospectively included if they had symptoms of chikungunya disease according to the 'case definition' of the National Institute of Communicable Diseases, Directorate General of Health Services, Government of India. The criteria were an acute illness characterized by the sudden onset of fever and several symptoms such as joint pain, headache, backache, photophobia, and eruption during an epidemic of chikungunya fever in the absence of confirmatory serological tests.

Materials and methods: A total of 115 patients (65 men and 50 women) who satisfied the above criteria were enrolled for the study.

Results: An erythematous maculopapular rash subsiding without any sequelae in 3-4 days was the most common cutaneous finding in our patients. Genital ulcers distributed predominantly over the scrotum and base of the penile shaft in men and labia majora in women were the second most common manifestation. Other manifestations included tenderness/edema of hands and feet, grouped hyperpigmented macules over the nose and cheeks, fixed drug eruptions, erythema nodosum, erythema multiformae, generalized urticarial eruptions, and flare up of pre-existing psoriasis and lichen planus.

Conclusions: To conclude, a plethora of cutaneous manifestations were noted in suspected cases of chikungunya disease. Genital ulcers, to the best of our knowledge, have not been reported during the earlier epidemics but have been reported by others during the present one.

No MeSH data available.


Related in: MedlinePlus

Diffuse erythema of scrotum with erosions
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Figure 0002: Diffuse erythema of scrotum with erosions

Mentions: The most common cutaneous finding was an erythematous maculopapular exanthem seen in 41 patients [Figure 1]. Genital ulcers were seen in 27 (20 men, 7 women) patients [Figures 2 and 3]. Associated bilateral, tender, inguinal lymphadenopathy was seen in seven of the patients. In seven of these patients oral ulcers resembling minor aphthae were seen. Tenderness/edema of hands and feet was observed in 24 patients and in half of these patients it was either concomitant with macular exanthems or with ulcers on the genitalia. Twelve patients showed grouped, hyperpigmented macules coalescing in some areas, distributed predominantly over the nose and cheeks [Figure 4]. Five patients showed discrete, scattered hyperpigmented macules over the face and trunk. The number of lesions ranged from 1-3. Three patients had tender, deep-seated nodules scattered over the distal part of the extremities (erythema nodosum type). Two patients had targetoid lesions over the extremities and trunk simulating an erythema multiform-like eruption. Two patients had generalized urticarial eruptions. Flare up of pre-existing psoriasis and lichen planus was noted in six and four patients respectively. One patient had multiple crusted lesions on the right side of upper lip and angle of mouth [Table 1].


Cutaneous manifestations in patients suspected of chikungunya disease.

Prashant S, Kumar AS, Basheeruddin DD, Chowdhary TN, Madhu B - Indian J Dermatol (2009)

Diffuse erythema of scrotum with erosions
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2807151&req=5

Figure 0002: Diffuse erythema of scrotum with erosions
Mentions: The most common cutaneous finding was an erythematous maculopapular exanthem seen in 41 patients [Figure 1]. Genital ulcers were seen in 27 (20 men, 7 women) patients [Figures 2 and 3]. Associated bilateral, tender, inguinal lymphadenopathy was seen in seven of the patients. In seven of these patients oral ulcers resembling minor aphthae were seen. Tenderness/edema of hands and feet was observed in 24 patients and in half of these patients it was either concomitant with macular exanthems or with ulcers on the genitalia. Twelve patients showed grouped, hyperpigmented macules coalescing in some areas, distributed predominantly over the nose and cheeks [Figure 4]. Five patients showed discrete, scattered hyperpigmented macules over the face and trunk. The number of lesions ranged from 1-3. Three patients had tender, deep-seated nodules scattered over the distal part of the extremities (erythema nodosum type). Two patients had targetoid lesions over the extremities and trunk simulating an erythema multiform-like eruption. Two patients had generalized urticarial eruptions. Flare up of pre-existing psoriasis and lichen planus was noted in six and four patients respectively. One patient had multiple crusted lesions on the right side of upper lip and angle of mouth [Table 1].

Bottom Line: Genital ulcers distributed predominantly over the scrotum and base of the penile shaft in men and labia majora in women were the second most common manifestation.Other manifestations included tenderness/edema of hands and feet, grouped hyperpigmented macules over the nose and cheeks, fixed drug eruptions, erythema nodosum, erythema multiformae, generalized urticarial eruptions, and flare up of pre-existing psoriasis and lichen planus.Genital ulcers, to the best of our knowledge, have not been reported during the earlier epidemics but have been reported by others during the present one.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology and Venereology, Deccan College of Medical Sciences and Allied Institutes i.e., OwaisiHospital and Princess Esra Hospital, India. prashantsoma@yahoo.com

ABSTRACT

Context: An epidemic of chikungunya disease occurred in India during late 2005 through 2006 affecting nearly 1,400,000 people.

Aim: To study the cutaneous manifestations in suspected cases of chikungunya disease.

Settings and design: Patients who attended our outpatient departments from January 2006 to September 2006 were prospectively included if they had symptoms of chikungunya disease according to the 'case definition' of the National Institute of Communicable Diseases, Directorate General of Health Services, Government of India. The criteria were an acute illness characterized by the sudden onset of fever and several symptoms such as joint pain, headache, backache, photophobia, and eruption during an epidemic of chikungunya fever in the absence of confirmatory serological tests.

Materials and methods: A total of 115 patients (65 men and 50 women) who satisfied the above criteria were enrolled for the study.

Results: An erythematous maculopapular rash subsiding without any sequelae in 3-4 days was the most common cutaneous finding in our patients. Genital ulcers distributed predominantly over the scrotum and base of the penile shaft in men and labia majora in women were the second most common manifestation. Other manifestations included tenderness/edema of hands and feet, grouped hyperpigmented macules over the nose and cheeks, fixed drug eruptions, erythema nodosum, erythema multiformae, generalized urticarial eruptions, and flare up of pre-existing psoriasis and lichen planus.

Conclusions: To conclude, a plethora of cutaneous manifestations were noted in suspected cases of chikungunya disease. Genital ulcers, to the best of our knowledge, have not been reported during the earlier epidemics but have been reported by others during the present one.

No MeSH data available.


Related in: MedlinePlus