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Mucocutaneous manifestations of Dengue fever.

Thomas EA, John M, Kanish B - Indian J Dermatol (2010)

Bottom Line: Dengue viral infection is a cause of considerable morbidity and mortality and may be associated with a variety of mucocutaneous manifestations that may provide important early clues to the diagnosis of this condition.Cutaneous and mucosal findings like confluent erythema, morbilliform eruptions, and hemorrhagic lesions may figure prominently in the clinical features of dengue.The differential diagnoses include a large number of bacterial and viral exanthems as well as drug rash.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Christian Medical College, Ludhiana, India. emyabi@gmail.com

ABSTRACT
Dengue viral infection is a cause of considerable morbidity and mortality and may be associated with a variety of mucocutaneous manifestations that may provide important early clues to the diagnosis of this condition. Cutaneous and mucosal findings like confluent erythema, morbilliform eruptions, and hemorrhagic lesions may figure prominently in the clinical features of dengue. The differential diagnoses include a large number of bacterial and viral exanthems as well as drug rash.

No MeSH data available.


Related in: MedlinePlus

Confluent erythematosus rash with island of sparing
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Figure 0002: Confluent erythematosus rash with island of sparing

Mentions: The characteristic exanthem of DF is estimated to occur in 50-82% of patients with DF.[89] Cutaneous findings figure prominently in the clinical manifestations of DF and DHF. In DF, the initial rash is a transient flushing erythema of face that typically occurs shortly before or within the first 24-48 hours of the onset of symptoms and is thought to be the result of capillary dilatation. The second rash usually occurs 3-6 days after the onset of fever and it is characterized by asymptomatic maculopapular or morbilliform eruption [Figure 1]. In some cases, individual lesions may coalesce and are then seen as generalized confluent erythema with petechiae and rounded islands of sparing-“white islands in a sea of red”[810] [Figure 2] and is thought to be due to an immune response to the virus. The rash in DF is usually asymptomatic, pruritus being reported in a substantial minority of patients in different studies; that is, 16% and 27.6%.[1112] Some patients display only the initial rash and recover completely, while others develop the more generalized eruption.[13] The generalized rash characteristically starts on the dorsum of the hands and feet and spreads to the arms, legs, and torso and it lasts for several days and subsides without desquamation. The morbilliform, maculopapular rash usually spares palms and soles. Less frequently, rashes of two other types may occur.[11] An eruption of fine macule over pressure areas may accompany the premonitory symptoms and herald the onset of fever. In some cases, the end of the fever is also marked by cutaneous changes in the form of a purpuric eruption on the hands, forearms, feet and legs, and in the mouth. Hemorrhagic manifestations on the skin such as petechiae [Figure 3], purpura, or ecchymosis with positive tourniquet test are commonly seen in DHF and DSS and rarely in DF. Tourniquet test is performed by inflating a blood pressure cuff on the upper aspect of arm to a point midway between systolic and diastolic pressures for 5 minutes. The test is considered positive when >20 petechiae/2.5 cm2 are observed.[13] Hemorrhagic manifestations usually appear 4-5 days after the onset of fever.


Mucocutaneous manifestations of Dengue fever.

Thomas EA, John M, Kanish B - Indian J Dermatol (2010)

Confluent erythematosus rash with island of sparing
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2856380&req=5

Figure 0002: Confluent erythematosus rash with island of sparing
Mentions: The characteristic exanthem of DF is estimated to occur in 50-82% of patients with DF.[89] Cutaneous findings figure prominently in the clinical manifestations of DF and DHF. In DF, the initial rash is a transient flushing erythema of face that typically occurs shortly before or within the first 24-48 hours of the onset of symptoms and is thought to be the result of capillary dilatation. The second rash usually occurs 3-6 days after the onset of fever and it is characterized by asymptomatic maculopapular or morbilliform eruption [Figure 1]. In some cases, individual lesions may coalesce and are then seen as generalized confluent erythema with petechiae and rounded islands of sparing-“white islands in a sea of red”[810] [Figure 2] and is thought to be due to an immune response to the virus. The rash in DF is usually asymptomatic, pruritus being reported in a substantial minority of patients in different studies; that is, 16% and 27.6%.[1112] Some patients display only the initial rash and recover completely, while others develop the more generalized eruption.[13] The generalized rash characteristically starts on the dorsum of the hands and feet and spreads to the arms, legs, and torso and it lasts for several days and subsides without desquamation. The morbilliform, maculopapular rash usually spares palms and soles. Less frequently, rashes of two other types may occur.[11] An eruption of fine macule over pressure areas may accompany the premonitory symptoms and herald the onset of fever. In some cases, the end of the fever is also marked by cutaneous changes in the form of a purpuric eruption on the hands, forearms, feet and legs, and in the mouth. Hemorrhagic manifestations on the skin such as petechiae [Figure 3], purpura, or ecchymosis with positive tourniquet test are commonly seen in DHF and DSS and rarely in DF. Tourniquet test is performed by inflating a blood pressure cuff on the upper aspect of arm to a point midway between systolic and diastolic pressures for 5 minutes. The test is considered positive when >20 petechiae/2.5 cm2 are observed.[13] Hemorrhagic manifestations usually appear 4-5 days after the onset of fever.

Bottom Line: Dengue viral infection is a cause of considerable morbidity and mortality and may be associated with a variety of mucocutaneous manifestations that may provide important early clues to the diagnosis of this condition.Cutaneous and mucosal findings like confluent erythema, morbilliform eruptions, and hemorrhagic lesions may figure prominently in the clinical features of dengue.The differential diagnoses include a large number of bacterial and viral exanthems as well as drug rash.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Christian Medical College, Ludhiana, India. emyabi@gmail.com

ABSTRACT
Dengue viral infection is a cause of considerable morbidity and mortality and may be associated with a variety of mucocutaneous manifestations that may provide important early clues to the diagnosis of this condition. Cutaneous and mucosal findings like confluent erythema, morbilliform eruptions, and hemorrhagic lesions may figure prominently in the clinical features of dengue. The differential diagnoses include a large number of bacterial and viral exanthems as well as drug rash.

No MeSH data available.


Related in: MedlinePlus