Skin involvement in patients of dengue fever during the 2011 epidemic in Lahore, Pakistan

To observe the skin changes in patients of dengue fever. In this cross-sectional, observational study, 109 patients of dengue fever with cutaneous manifestations were enrolled from the dengue outpatient and inpatient departments of Lahore General Hospital, Lahore. This was done during the recent outbreak of dengue fever in Pakistan from 1[st] September 2011 to 31[st] October 2011. Demographic data of patients was recorded, cutaneous findings were noted and their percentages were calculated, consent for the photographs was taken. Out of 109 patients, 61 [56%] were males and 48 [44%] were females, male to female ratio being 1.3:1. Age range was 3 to 78 years. The mean age was 27.25 +/- 11.02 years. Cutaneous findings included blanchable erythema, observed in 47 [43%], followed by itching and burning in 33 [30.3%], maculopapular rash was seen in 17 [15.6%] patients, scaling in 11 [10.1%], herpes simplex was observed in 9 [8.3%] of the total patients, Petechiae/ecchymoses/purpura also in 9 [8.3%] and urticaria was the least common of the skin changes, occurring in only 4 [3.7%] patients. Mucosal involvement showed red eye in 41 [40.6%] patients. Oral mucosa showed diffuse erythema in 16 [14%] patients, candidiasis occurred in only 2 [1.9%] and oral aphthae presented in 2 [1.9%] patients. Cutaneous findings are commonly seen in patients of dengue fever. It may help in the early diagnosis of dengue fever, while the laboratory tests are still awaited

Orf in a patient of toxic epidermal necrolysis during hospital stay: an unusual scenario

Orf is a zoonotic infection seen in livestock handlers. We report a case of human to human transmission of orf infection in a patient of toxic epidermal necrolysis and his caretakers. To the best of our knowledge this is the first case of orf infection in the patient of toxic epidermal necrolysis