Clinical significance of skin rash in dengue fever: A focus on discomfort, complications, and disease outcome

Abstract

Cutaneous manifestations provide an important clue to dengue fever. In patients with dengue fever, those with skin rash tend to have itching and swelling of the palms/soles, however, those without skin rash tend to have more complications and poor disease outcomes.

Immune responses to dengue virus in the skin

“…In contrast to the site of initial virus infection, areas of skin with pathologic manifestations during the acute systemic stage of disease, which may be characterized by haemorrhaging or oedema, are usually not positive for DENV infection and, thus, these lesions are likely to be the result of the systemic inflammatory response [16]. Surprisingly, in one study, the early presence of rash or cutaneous manifestations of disease was associated with improved disease outcomes in human patients [17]. However, other studies noted that immune cells in the skin were activated at the onset of DSS [18], potentially reflecting the systemic inflammatory response.…”

Dengue fever rash: white islands in a sea of red

“…In a recent study, the disease course and complications in patients with skin rash were not found to be worse than patients who did not have skin rash. On the other hand, more hemorrhagic manifestations, genital mucosal involvement, and higher incidence of platelet transfusion were noted in patients without skin rash …”

“…Its major vector is the mosquito Aedes aegypti. Clinical manifestations of DF vary from a mild self‐limiting illness to severe and fatal forms like dengue hemorrhagic fever and dengue shock syndrome …”

“…Clinical manifestations of DF vary from a mild self-limiting illness to severe and fatal forms like dengue hemorrhagic fever and dengue shock syndrome. 1 Cutaneous eruptions are commonly seen in association with DF. In different observational studies conducted in different countries, skin rash has been noticed in 46.8-82% of the cases.…”

“…On the other hand, more hemorrhagic manifestations, genital mucosal involvement, and higher incidence of platelet transfusion were noted in patients without skin rash. 1…”