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

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• 作者：Hsin-Wei Huang¹ ; Han-Chi Tseng¹ ; Chih-Hung Lee¹ ; Hung-Yi Chuang² ; ³ ; Shang-Hung Lin¹ ; ^{hongfufu@gmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Dengue ; Exanthema ; Pruritus ; Serology
• 刊名：Asian Pacific Journal of Tropical Medicine
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：9
• 期：7
• 页码：713-718
• 全文大小：892 K

文摘

To assess whether the cutaneous features in patients with dengue fever are associated with abnormal blood biochemistry, complications, and poor disease outcome.

Methods

Forty five patients with dengue fever were identified at a medical center in Kaohsiung, Taiwan, from September to November 2014. All cases were exclusively caused by type 1 dengue virus. Patients were classified into two groups, based on the presence or absence of skin rash, and their rash was subclassified into maculopapular, morbilliform, and petechial types. Clinical symptoms, laboratory data, disease outcome, and complications were compared between the two groups.

Results

Thirty two patients with dengue fever developed skin rash (SP group, n = 32) while the rest of 13 did not (SN group, n = 13). The patient numbers in the maculopapular, morbilliform, and petechial group were 4, 21, and 7, respectively. The SP group was younger (P = 0.001), experienced more pruritus (P = 0.008) and more swollen palms/soles (P = 0.015) than the SN group. However, the SN group had greater genital mucosa involvement (P = 0.008), higher platelet transfusion rate (P = 0.003), and lower hemoglobin and hematocrit levels (P = 0.030) than the SP group. Patients with morbilliform lesions had a higher incidence of palm/sole swelling, less genital mucosal involvement, and a lower platelet transfusion rate than did patients with maculopapular or petechial lesions.

Conclusions

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.