Islands of White in a Sea of Red: A Cutaneous Manifestation of Dengue Fever in a Pregnant Woman


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Authors

  • Fadlul Azim Fauzi Mansur Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Persiaran Ilmu, Putra Nilai, 71800, Negeri Sembilan, Malaysia
  • Nurul Azmawati Mohamed Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Persiaran Ilmu, Putra Nilai, 71800, Negeri Sembilan, Malaysia

DOI:

https://doi.org/10.33102/mjosht.v7i3.203

Keywords:

dengue, island of white in a sea of red, skin

Abstract

Dengue fever is a significant public health problem in Asia, resulting in serious morbidity and even mortality. It is mainly known for causing severe constitutional symptoms and bleeding, often resulting in haemorrhagic shock. Dengue fever may manifest cutaneously in several forms. These include petechial rash, maculopapular rash and what has been termed as islands of white in a sea of red. Most can be attributed to capillary fragility, which led to tests such as the tourniquet test. This case highlights the dengue fever cutaneous presentation of islands of white in a sea of red in a multigravida woman during her first trimester. Her husband and son who was infected at the same time did not develop similar skin condition but developed the more common maculopapular and petechial rashes. The pathophysiology of such lesions is not well understood, and its relation to pregnancy is not known. Blood investigations were typical of dengue fever. The outcome of the patient’s pregnancy was also normal. This case highlights the need for doctors to look out for such lesions in dengue patients.

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References

World Health Organisation (WHO), “Dengue and severe dengue,” (2020). https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue.

Suppiah, J., Ching, S. M., Amin-Nordin, S., Mat-Nor, L. A., Ahmad-Najimudin, N. A., Low, G. K. K., ... & Chee, H. Y. (2018). Clinical manifestations of dengue in relation to dengue serotype and genotype in Malaysia: A retrospective observational study. PLoS neglected tropical diseases, 12(9), e0006817.

Lovera, D., Martínez-Cuellar, C., Galeano, F., Amarilla, S., Vazquez, C., & Arbo, A. (2019). Clinical manifestations of primary and secondary dengue in Paraguay and its relation to virus serotype. The Journal of Infection in Developing Countries, 13(12), 1127-1134.

Thomas, E. A., John, M., & Bhatia, A. (2007). Cutaneous manifestations of dengue viral infection in Punjab (north India). International journal of dermatology, 46(7), 715-719.

Halsey, E. S., Marks, M. A., Gotuzzo, E., Fiestas, V., Suarez, L., Vargas, J., ... & Laguna-Torres, V. A. (2012). Correlation of serotype-specific dengue virus infection with clinical manifestations. PLoS neglected tropical diseases, 6(5), e1638.

Azfar, N. A., Malik, L. M., Jamil, A., Jahangir, M., Tirmizi, N., Majid, A., ... & Malik, M. (2012). Cutaneous manifestations in patients of dengue fever. Journal of Pakistan Association of Dermatologists, 22(4).

Mishra, A. K., George, A. A., & Abhilash, K. P. P. (2018). The relationship between skin rash and outcome in dengue. Journal of vector borne diseases, 55(4), 310.

Paixao, E. S., Harron, K., Campbell, O., Teixeira, M. G., Maria da Conceição, N. C., Barreto, M. L., & Rodrigues, L. C. (2018). Dengue in pregnancy and maternal mortality: a cohort analysis using routine data. Scientific reports, 8(1), 1-6.

Paixão, E. S., Teixeira, M. G., Maria da Conceição, N. C., Barreto, M. L., & Rodrigues, L. C. (2018). Symptomatic dengue during pregnancy and congenital neurologic malformations. Emerging infectious diseases, 24(9), 1748.

Agarwal, K., Malik, S., & Mittal, P. (2017). A retrospective analysis of the symptoms and course of dengue infection during pregnancy. International Journal of Gynecology & Obstetrics, 139(1), 4-8.

Brar, R., Sikka, P., Suri, V., Singh, M. P., Suri, V., Mohindra, R., & Biswal, M. (2021). Maternal and fetal outcomes of dengue fever in pregnancy: a large prospective and descriptive observational study. Archives of Gynecology and Obstetrics, 304(1), 91-100.

Chadwick, D., Arch, B., Wilder-Smith, A., & Paton, N. (2006). Distinguishing dengue fever from other infections on the basis of simple clinical and laboratory features: application of logistic regression analysis. Journal of Clinical Virology, 35(2), 147-153.

Pincus, L. B., Grossman, M. E., & Fox, L. P. (2008). The exanthem of dengue fever: Clinical features of two US tourists traveling abroad. Journal of the American Academy of Dermatology, 58(2), 308-316.

Radakovic-Fijan, S., Graninger, W., Müller, C., Hönigsmann, H., & Tanew, A. (2002). Dengue hemorrhagic fever in a British travel guide. Journal of the American Academy of Dermatology, 46(3), 430-433.

Prakash, N., Prakash, J., & Prakash, A. (2016). Dengue fever: Diagnosis may be skin deep. Indian Journal of Medical Specialities, 7(4), 142-144.

Gehlot, H., Yadav, O. P., Sharma, S., Nagar, G., Yadav, A., & Gupta, P. (2017). A study of dengue fever in pregnancy and its maternal and fetal prognosis. Int J Reprod Contracept Obstet Gynecol, 6, 3414.

Published

2021-09-01
CITATION
DOI: 10.33102/mjosht.v7i3.203
Published: 2021-09-01

How to Cite

Mansur, F. A. F., & Mohamed, N. A. (2021). Islands of White in a Sea of Red: A Cutaneous Manifestation of Dengue Fever in a Pregnant Woman. Malaysian Journal of Science Health & Technology, 7(3), 64–66. https://doi.org/10.33102/mjosht.v7i3.203