Cutaneous manifestations of chikungunya fever: observations made during a recent outbreak in south India.

UNLABELLED: BACKGROUND; Chikungunya fever is an Aedes mosquito-borne Arbo viral illness with significant morbidity. METHODS: In a recent outbreak of the disease in south India, the dermatologic manifestations of 145 patients attending a tertiary care hospital were recorded. RESULTS: All age groups were affected, including newborns. Some of the cutaneous features were observed during the acute stage of the illness, and others during convalescence or thereafter. Pigmentary changes were found to be the most common cutaneous finding (42%), followed by maculopapular eruption (33%) and intertriginous aphthous-like ulcers (21.37%). Lesions with significant morbidity were generalized vesiculobullous eruptions (2.75%), found only in infants, lymphedema, and intertriginous aphthous-like ulcers. Exacerbation of existing dermatoses, such as psoriasis, and unmasking of undiagnosed Hansen's disease were observed. A perivascular lymphocytic infiltrate was a consistent histopathologic finding in all types of skin lesions. All patients responded well to symptomatic, conservative treatment. CONCLUSIONS: The cutaneous findings hitherto not reported may be the result of the African genotype of the virus detected during this outbreak in India.

Generalized anetoderma in a patient with HIV and dual mycobacterial infection.

A middle-aged HIV infected man receiving treatment for pulmonary tuberculosis, presented with a febrile illness along with evanescent, erythematous nodular lesions all over the body. On examination, he had features suggestive of lepromatous leprosy with lesions of erythema nodosum leprosum. In addition, there were multiple small, circumscribed areas of slack skin, clinically and histopathologically suggestive of anetoderma. Both leprosy and HIV infection are known to give rise to lesions of anetoderma. Pathogenesis of anetoderma in these infectious conditions is discussed.

Greither's disease.

A 14-year-old girl with diffuse palmoplantar keratoderma with hyperhidrosis and progressive extension of keratoderma to the dorsum of the hands and feet is reported. The inheritance pattern was autosomal dominant.

Inflammatory cutaneous metastasis as a presenting feature of bronchogenic carcinoma.

An elderly man with a long history of smoking presented with an excruciatingly painful mass of short duration on the left side of the neck, without any systemic complaint. Clinical and radiological examination revealed left upper lobe consolidation which was proved to be secondary to bronchogenic carcinoma. Histopathological findings from a skin biopsy from the neck mass were consistent with inflammatory cutaneous metastasis. Interestingly, this was the presenting feature of the underlying malignancy in this patient. This pattern of cutaneous metastasis has rarely been reported in association with bronchogenic carcinoma.

Vitiligo and psoriasis: coexistence with colocalization.

A 20-year-old male patient with vitiligo who developed psoriasis is reported here. There was co-existence of both diseases and co-habitation lesions at places. Clinical heterogenicity of both diseases and new conclusions are discussed.

Papuloerythroderma of ofuji.

A 60-year old male with papulo erythroderma of Ofuji is presented here for its rarity. The characteristic 'deck chair' sign was present. Response to PUVA therapy was noted.