Myriad cutaneous presentation of chikungunya fever during recent epidemic in Gujarat: a case study of 124 cases

Background: Chikungunya fever (CKG) epidemic had been recently re-emerged in Gujarat affecting large population. It is an acute viral infection caused by Togavirus, transmitted by Aedes mosquitos, can present with abrupt onset of fever, severe arthralgia, constitutional symptoms and cutaneous manifestations. We have reviewed cutaneous manifestations of CKG during recent epidemic (July-October 2017). The object of the study was to determine incidence of various cutaneous manifestations of Chikungunya fever. Methods: A total of 124 patients (56 males and 68 females) with cutaneous manifestations of CKG were enrolled in the study and serological confirmation was done. Results: Cutaneous manifestations were found more in females. Generalized erythematous maculo-papular rash was the most common finding (62.9%). Vesiculo-bullous eruption (7.25%) and toxic epidermal necrolysis-like lesions sparing mucosa (4.03%) were the other interesting findings. Different types of pigmentation were observed with striking nasal pigmentation in 7.25% patients. Aphthous like ulcers in intertriginous area were seen in 8.87%. There was flare up of existing conditions like Still’s disease and psoriasis. Conclusions: A wide variety of cutaneous manifestations of CKG with an unusual presentation was encountered with confirmed serological evidence.