Department of Dermatology, Medical College, Calicut, Kerala, India.
Indian J Dermatol Venereol Leprol. 2010 Nov-Dec;76(6):671-6. doi: 10.4103/0378-6323.72466.
There was a recent epidemic of chikungunya (CKG) in Calicut and other northern districts of Kerala, South India, affecting thousands of people.
To study the cutaneous manifestations of CKG and to have a serological and histopathological correlation.
A total of 162 patients (63 males and 99 females) with cutaneous manifestations of CKG were enrolled in the study and serological confirmation was done with capture IgM ELISA for CKG. Skin biopsy was done in all representative cases.
Cutaneous manifestations were found more in females. There were 23 children, the youngest being 39 days old. Generalized erythematous macular rash was the most common finding. Vesicles and bullae were also common especially in infants. Localized erythema of the nose and pinnae, erythema and swelling of the pre existing scars and striae and toxic epidermal necrolysis-like lesions sparing mucosae were the other interesting findings. Different types of pigmentation were observed with a striking nose pigmentation in a large number of patients, by looking at which even a retrospective diagnosis of CKG could be made. Hence we suggest this peculiar pigmentation may be called "chik sign". There was flare up of existing dermatoses like psoriasis, lichen planus and unmasking of Hansen's disease with type 1 reaction. Serological tests were positive in 97%. Some hitherto unreported histopathologic findings like melanophages in the erythematous rashes were observed.
A spectrum of cutaneous manifestations of CKG with a wide variety of unusual presentations with confirmed serological and histopathological evidence was encountered.
印度南部喀拉拉邦的卡利卡特和其他北部地区最近爆发了基孔肯雅热（CKG）疫情，数千人受到感染。
研究 CKG 的皮肤表现，并进行血清学和组织病理学相关性研究。
共纳入 162 例有 CKG 皮肤表现的患者（63 名男性和 99 名女性），采用捕获 IgM ELISA 法进行 CKG 的血清学确认。所有有代表性的病例均进行皮肤活检。
皮肤表现多见于女性，其中有 23 例为儿童，最小的仅 39 天。最常见的发现是全身性红斑性斑丘疹。水疱和大疱也很常见，尤其是在婴儿中。局部红斑的鼻子和耳廓、先前存在的疤痕和条纹的红斑和肿胀以及无黏膜受累的中毒性表皮坏死松解样病变也是其他有趣的发现。观察到不同类型的色素沉着，许多患者的鼻子有明显的色素沉着，甚至可以通过这种色素沉着进行回顾性的 CKG 诊断。因此，我们建议这种特殊的色素沉着可能被称为“chik 征”。现有的皮肤病如银屑病、扁平苔藓和汉森病 1 型反应的表现加重。血清学检测阳性率为 97%。观察到一些以前未报道过的组织病理学发现，如红斑性皮疹中的黑素细胞。
遇到了 CKG 的一系列皮肤表现，包括广泛的不寻常表现，具有明确的血清学和组织病理学证据。
