Post-chikungunya hyperpigmentation

Sil, Abheek; Biswas, Surajit Kumar; Bhanja, Dibyendu Bikash; Das, Sisir; Panigrahi, Avik

doi:10.1136/postgradmedj-2020-137504

Cited by 6 publications

(5 citation statements)

References 2 publications

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“…As in the previous case, the patient had been treated with sulfasalazine for joint pain in the previous months, making it difficult to link chikungunya virus to DRESS syndrome [ 108 ]. 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.…”

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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“…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.…”

Section: Sirmentioning

confidence: 62%

“…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.…”

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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“…19,20 This hyperpigmentation has been described as a 'sign of chikungunya' and should be considered a specific clinical marker of chikungunya fever, especially in environments with limitations to retrospective serological diagnosis. 21,22 The chronic phase is defined by symptoms that persist for more than 3 months and usually consist of persistent arthralgia/arthritis in the compromised joints during the acute phase of the disease 23 as well as chronic fatigue and depression. 16,24 In addition to the classic symptoms observed in chikungunya fever, less common clinical conditions, such as encephalitis, convulsions, heart failure, arrhythmias, renal failure, and eye diseases, have already been reported; thus, demonstrating the ability of CHIKV to cause several and severe damage to the affected patients.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…Skin manifestations such as hyperpigmentation are multiple macules and discrete brownish‐black freckle‐like patches distributed over the tip and brim of the nose 19,20 . This hyperpigmentation has been described as a ‘sign of chikungunya’ and should be considered a specific clinical marker of chikungunya fever, especially in environments with limitations to retrospective serological diagnosis 21,22 …”

Section: Clinical Manifestationsmentioning

confidence: 99%

Immunological impact of cytokines on the chikungunya virus pathophysiology: A literature narrative review

Nunes

Sousa

Smith

et al. 2023

Reviews in Medical Virology

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The chikungunya virus (CHIKV) is a member of the genus Alphavirus, family Togaviridae. CHIKV causes an acute systemic febrile condition, accompanied by severe polyarthralgia, intense muscle pain, and maculopapular exanthema, which may still occur in many patients. In rare cases, unusual symptoms may occur, eventually worsening the condition and resulting in a fatal outcome. It is a single‐stranded, non‐segmented RNA virus with a genome of approximately 11,805 nucleotides that organises a genetic and molecular chain that encodes non‐structural proteins (nsP1, nsP2, nsP3, nsP4) and structural proteins (E3, E2, 6K, and E1). The fundamental role of immune response in the evolution of the disease is known. Understanding the role of immune response in the pathogenesis of CHIKV infection is challenging. In this context, innate and adaptive immune responses establish a connective interface that induces the production of various mediators that modulate the strategy of inhibiting viral replication. However, the immune escape articulated by the virus indicates that the action of pro‐and anti‐inflammatory cytokines contributes to the worsening of the disease and potentiates tissue damage with joint involvement. In this review, we discuss the role of the primary pro‐and anti‐inflammatory cytokines in the immunopathological processes of chikungunya fever.

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Post-chikungunya hyperpigmentation

Cited by 6 publications

References 2 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

Immunological impact of cytokines on the chikungunya virus pathophysiology: A literature narrative review

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