CONVALESCENT RASH OF DENGUE

Vigneshvarprashanth Umapathy¹, G. Dominic Rodriguez²

¹Resident Internal Medicine, Kauvery Hospital, Tennur, Trichy

²HOD Internal Medicine, Kauvery Hospital, Tennur, Trichy

Correspondence: [email protected], [email protected]

Case Presentation

A 21-year-old girl presented to the emergency department on the 10th day of illness with a history of fever, vomiting, myalgia, and rash. She was afebrile for the last 3 days. She noticed the rash on the 8th day of illness, which started in the upper limbs, and then subsequently involved the lower limbs and the back as well.

The rash was erythematous with hypopigmented macules. On evaluation, she was positive for the Dengue NS1 antigen and Dengue IgM antibody. The platelet count was just above the normal range. She was also found to have hepatitis.

Discussion

There are 3 phases of dengue fever; Febrile, Critical, and Convalescent or recovery phase. The below images are typical of convalescent rash of dengue, occurring in the recovery phase, characterized by small areas of unaffected skin in the background of erythema, referred to as ‘islands of white in a sea of red’ (black arrowheads point to the white islands). She made a good clinical recovery.