Zika Virus Skin Rash: Another Symptom of Infection?

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A recent study details a case of a man with a confirmed Zika virus infection accompanied by papular descending eruption, petechiae on his palate, and hyperemic sclerae.

As clinicians continue to struggle with the differential diagnosis between Zika virus infection and two closely related diseases—Dengue virus and Chikungunya—new research out of the Hofstra/Northwell School of Medicine may provide them with a new diagnostic marker—a precise characterization of how it manifests on the skin.

In a case report published in June by the Journal of the American Medical Association—Dermatology, Amit Garg, MD and colleagues describe the case of a 44-year-old male who had travelled to Puerto Rico, where local transmission of Zika via Aedes aegypti mosquitos has been well documented, with confirmed infection. Dr. Garg et al noted that the patient had a diffuse papular descending eruption, petechiae on his palate, and hyperemic sclerae.

The authors could not be reached for comment. However, they noted in their concluding remarks that increased understanding of the mucocutaneous findings associated with Zika virus infection may assist clinicians in recognizing the disease and eliminating it from consideration when patients present with other more common erythematous eruptions. They wrote, “A detailed awareness of mucocutaneous findings associated with Zika virus infection will support its early recognition and will facilitate elimination of Zika infection from consideration for concerned patients who present with other, more common erythematous eruptions.”

A detailed awareness of mucocutaneous findings associated with Zika virus infection will support its early recognition and will facilitate elimination of Zika infection from consideration for concerned patients who present with other, more common erythematous eruptions.

Earlier research by clinicians in Brazil has established the most common signs or symptoms of Zika as: macular or maculopapular rash (97%), followed by pruritus (79%), prostration (73%), headache (66%), arthralgias (63%), myalgias (61%), nonpurulent conjunctivitis (56%), and lower back pain (51%).

Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.

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