Hyperpigmentation and chikungunya fever

Srivastava, Ankita

doi:10.1590/abd1806-4841.20165805

Cited by 7 publications

(5 citation statements)

References 5 publications

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“…Moreover, chikungunya virus-infected patients can develop mucocutaneous changes that may mimic the clinical presentation of DIHS/DRESS, thus making a differential diagnosis more difficult [ 109 , 110 ]. Notably, the macular hyperpigmentation of the nose and cheeks that sometimes follows chikungunya infection (Chik sign) initially appears as a maculopapular exanthem [ 111 ] resembling DRESS rash. In both scenarios, activation of skin-resident memory T-cells may account for anti-infectious responses and hypersensitivity reactions, such as DRESS [ 112 ].…”

Section: Aetiology and Pathogenesismentioning

confidence: 99%

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Focus on the Pathophysiological and Diagnostic Role of Viruses

et al. 2023

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Drug reaction with eosinophilia and systemic symptoms (DRESS) is a heterogeneous, multiorgan and potentially life-threatening drug-hypersensitivity reaction (DHR) that occurs several days or weeks after drug initiation or discontinuation. DHRs constitute an emerging issue for public health, due to population aging, growing multi-organ morbidity, and subsequent enhanced drug prescriptions. DRESS has more consistently been associated with anticonvulsants, allopurinol and antibiotics, such as sulphonamides and vancomycin, although new drugs are increasingly reported as culprit agents. Reactivation of latent infectious agents such as viruses (especially Herpesviridae) plays a key role in prompting and sustaining aberrant T-cell and eosinophil responses to drugs and pathogens, ultimately causing organ damage. However, the boundaries of the impact of viral agents in the pathophysiology of DRESS are still ill-defined. Along with growing awareness of the multifaceted aspects of immune perturbation caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the ongoing SARS-CoV-2-related disease (COVID-19) pandemic, novel interest has been sparked towards DRESS and the potential interactions among antiviral and anti-drug inflammatory responses. In this review, we summarised the most recent evidence on pathophysiological mechanisms, diagnostic approaches, and clinical management of DRESS with the aim of increasing awareness on this syndrome and possibly suggesting clues for future research in this field.

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Section: Aetiology and Pathogenesismentioning

confidence: 99%

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Focus on the Pathophysiological and Diagnostic Role of Viruses

et al. 2023

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“…Therapeutic measures like photo‐protection, sunscreen and topical usage of hypopigmenting agents of hydroquinone cream with or without short course topical steroids for a month have shown good response in treating hyperpigmentation in CF patients. 4 , 9 For our patients, we had to continue topical therapy for nearly 3–4 months for clinical improvement to be appreciable.…”

Section: Tablementioning

confidence: 99%

‘COVID nose’ – A unique post–COVID pigmentary sequelae reminiscing Chik sign: A descriptive case series

Sil

Panigrahi²,

Chandra

et al. 2022

Acad Dermatol Venereol

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“…Therapeutic measures like photo-protection, sunscreen and topical usage of hypopigmenting agents of hydroquinone cream with or without short course topical steroids for a month have shown good response in treating hyperpigmentation in CF patients. 4,9 For our patients, we had to continue topical therapy for nearly 3-4 months for clinical improvement to be appreciable.In conclusion, we highlight here a unique series of patients where a pigmentary sequelae ('COVID nose') was directly ascribed to COVID-19. 'Chik sign', which is considered a feature quite unique to CF, should also raise the suspicion of a preceding COVID-19 infection.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

Development of eruptive pseudoangiomatosis following immunization with COVISHIELD vaccine in an adult

Prarthana

Bakshi

Hanumanthu

et al. 2022

Acad Dermatol Venereol

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skin. The cause was subsequently found to be iatrogenicpolymixin B was prescribed to both patients to treat multidrug resistant bacterial infection. 2 The localized hyperpigmentation involving the centrofacial area that we observed in our patients was reminiscent of the 'Chik sign'. 3 In resource-limited settings, this classic pigmentary sequelae serves a cutaneous clue in making a retrospective diagnosis of chikungunya fever and rarely dengue. 4,5 The underlying pathology remains speculative. On histopathology, increased basal layer pigmentation, pigmentary incontinence and dermal melanophages with perivascular inflammatory infiltration have been observed. Thus, an increased intraepidermal melanin dispersion/retention triggered by the virus has been postulated as a cause for pigmentation. 6 Predominant affection of the centrofacial area indicates the possible role of ultraviolet radiation exposure in this patterned distribution of pigmentation. As a postviral event, this mechanistic reasoning may explain the pigmentary outcome in SARS-CoV-2-infected patients. Interestingly, accompanying postfebrile arthritis is a feature common to both the viral aetiologies (SARS-CoV-2 and chikungunya). 7 Thus, making a serological diagnosis is imperative in such cases. After excluding the common causes and given the temporal relation with COVID-19, the cause of the nasal pigmentation in these patients was attributed to SARS-CoV-2 infection.Hyperpigmentation associated with chikungunya fever (CF) usually develop after 1-3 weeks after fever defervescence. 6,8 In our set of patients, a slightly longer time gap was noted. Therapeutic measures like photo-protection, sunscreen and topical usage of hypopigmenting agents of hydroquinone cream with or without short course topical steroids for a month have shown good response in treating hyperpigmentation in CF patients. 4,9 For our patients, we had to continue topical therapy for nearly 3-4 months for clinical improvement to be appreciable.In conclusion, we highlight here a unique series of patients where a pigmentary sequelae ('COVID nose') was directly ascribed to COVID-19. 'Chik sign', which is considered a feature quite unique to CF, should also raise the suspicion of a preceding COVID-19 infection. We further implore clinicians to broaden the list of differentials for this presentation to include other viral aetiologies.

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Hyperpigmentation and chikungunya fever

Cited by 7 publications

References 5 publications

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Focus on the Pathophysiological and Diagnostic Role of Viruses

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Focus on the Pathophysiological and Diagnostic Role of Viruses

‘COVID nose’ – A unique post–COVID pigmentary sequelae reminiscing Chik sign: A descriptive case series

Development of eruptive pseudoangiomatosis following immunization with COVISHIELD vaccine in an adult

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