Study of varied cutaneous manifestations of chikungunya fever

Introduction: Chikungunya fever is an arboviral disease transmitted by infected Aedes mosquitoes. It is characterized by acute onset of fever, associated with severe disabling arthralgia. Mucocutaneous manifestations occur in about half of these patients. Aim: To study the mucocutaneous manifestations in suspected cases of chikungunya. Materials and Methods: Patients attending dermatology outpatient department with fever and rash were screened for chikungunya. Clinical examination was done and mucocutaneous manifestations recorded. Diagnosis was confirmed by serological testing. A total of 50 patients were enrolled in the study. Results: Generalized erythematous maculopapular rash was the most common cutaneous manifestation. Multiple ulcers with erythema over genital region in males was the second most common presentation. Centro facial pigmentation and discrete hyperpigmented macules on trunk and face, urticarial rash, crusted lesions near angle of mouth, erythema/edema over hands and feet were other findings. Generalized erythema multiforme like lesions were also observed in two patients. Vesiculobullous eruptions, which have been reported commonly only in infants, were found in one adult patient in our study. Exacerbation of pre-existing skin lesions and Erythema nodosum like lesions reported in literature were not seen in our study. Conclusion: Vesiculobullous lesions have been reported as a common cutaneous manifestation of chikungunya fever in infants. Vesiculobullous lesions occurring in an adult, however, have not been reported previously, to the best of our knowledge.