Dermatological manifestations of dengue fever

Each year dengue related infections are rising in tropical countries. There is not enough data available on dermatological manifestations of dengue fever. This study was conducted to investigate prevalence and type of dermatological manifestations of dengue fever [DF], Dngue Haemorrhagic Fever [DHF], and Dengue Shock Syndrome [DSS]. A Prospective study was contacted in Department of Medicine, Shaikh Zayed Hospital, Lahore, from 3[rd] Oct to 20[th] Nov 2010. Specific serological tests for DF were done in all 60 patients admitted with suspected diagnosis of DF, DHF or DSS. Forty-eight confirmed cases were evaluated for age, gender, mucocutaneous features and outcome of the disease. Forty-eight out of 60 patients had positive serology for dengue fever. Male to female ratio was 1.09:1. Their ages ranged 5-68 years with a mean of 31.5 +/- 15.2. DF, DHF and DSS were found in 71%, 19% and 10% respectively. Common dermatological presentations were oral mucous membrane congestion [66.67%], generalised morbiliform rash [64.58%] and eye congestion [64.58%]. Purpuric spots along with mucous membrane congestion, generalised morbiliform rash and eyes congestion was observed in 20.83%, 12.5% and 6.25% patients respectively. All except one patient improved clinically. One patient died of respiratory distress and haemorrhage on second day of admission. Dermatological features are significantly noticeable in dengue fever patients. These may help us in early diagnosis and better management of patients.

Interferon alfa and ribavirin induced hair changes

Combination therapy of lnterferon alfa and ribavirin in chronic hepatitis C has well documented cutaneous adverse effects. Most interesting of these has been reported on hair physiology. This study was conducted to determine the frequency and pattern of adverse effects involving hair in patients receiving combination of interferon alfa 2a and ribavirin for chronic hepatitis C. The study was conducted in Department of Dermatology, Division of Medicine Shaikh Zayed Hospital. Thirty Eight patients who completed treatment with interferon alfa 3 MIU subcutaneously thrice weekly] and 1200 mg ribavirin daily for 24 weeks were enrolled in this single-center study. The patient's response and examination finding particularly regarding involvement of hair was noted on a Pro forma. Thirty Two out of thirty eight [84%] patients noted adverse effects involving hair. The most frequent was diffuse hair loss and occurred in 27 patients [71 %]. Hypertrichosis of eyelashes [trichomegaly] and eyebrows [synophyrs] was observed in 18 [47%] and 16 [42%] patients respectively. Graying of hair was noted in 4 patients [11 %], while discoloration of moustache hair was seen in 2 patients [5%]. Epilation at the site of subcutaneous injection was noted in 10 patients [26%]. Alopecia areata was reported in 2 patients [5%]. It is concluded that adverse effects involving hair are frequent and varied [hair loss to excess hair growth] during combination therapy with Interferon alfa-2a and Ribavirin for chronic hepatitis C