Skin rash may be clue to dengue fever

By Arusha Campbell-Chambers

Dengue fever is a disease caused by the dengue virus, which is spread mostly by the Aedes aegypti mosquito. The mosquito usually passes on the virus during a bite at daytime. The virus is not directly spread from human to human.

Dengue fever is more common in tropical climates, especially during the rainy season. It may affect all age groups. Dengue haemorrhagic fever and dengue shock syndrome are more severe forms of the disease. The skin provides important clues to help diagnose dengue fever.

It usually takes between three and eight days after the mosquito bite for the symptoms to appear. During the first phase of the condition, there is usually a rapidly rising fever lasting three to seven days. In some cases, there may be an initial flushing redness of the face in the first one or two days. In addition to fever, patients may also have a severe headache, pain behind the eyes, joint pains, muscular pains, nausea and/or vomiting.

Skin rash after the fever

After this period, the fever tends to go away for a few hours to a few days during which a skin rash appears in 50 to 80 per cent of patients. There may be many reddish spots, reddish bumps and reddish/purplish blood spots under the skin. The rash may become grouped together to involve most areas of the skin, with small islands of normal skin in-between.

The rash typically begins on the hands and feet and then spreads to the arms, legs and trunk. It is not usually itchy in most cases. The rash can last from hours to several days and usually resolves without any stripping of the skin. Some individuals may get small fluid-filled bumps inside the mouth and/or redness and crusting of the lips and tongue. There are other viruses, bacteria and drugs which may cause rashes similar to dengue fever.

Bleeding under skin

Dengue fever may cause bleeding under the skin, bruising, nosebleeds, bloodshot eyes, bleeding from the gum, and in vomit and/or stool. These bleeding symptoms tend to be more common and more severe in dengue haemorrhagic fever and dengue shock syndrome. In dengue shock syndrome, the individual may also have cold, clammy skin, sweaty hands and feet, drowsiness, restlessness, a rapid pulse and low blood pressure because of shock or collapse of their blood circulation. This is a medical emergency, as it can be fatal if not treated urgently. Indeed, individuals with high fever and bleeding symptoms and/or symptoms of shock described above should be rushed to the hospital.

Don't take aspirin, ibuprofen

Medical personnel may perform a tourniquet test and laboratory tests to help diagnose and manage this disease. There is no specific curative drug available, and so treatment is supportive. This includes fluid replacement, rest and possibly hospitalisation. Pain can be treated with drugs like paracetamol. Aspirin and drugs like ibuprofen should be avoided in affected persons. Insect repellents, screens, coils, nets, vapour mats and the elimination of mosquito, breeding sites are critical to preventing the spread of dengue fever in our communities.

Dr Arusha Campbell-Chambers is a dermatologist and founder of Dermatology Solutions Skin Clinics & Medi-Spas; email: yourhealth@gleanerjm.com.