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Mucocutaneous findings, lesional skin associated with Zika virus infection
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Papular eruptions and other mucocutaneous findings were linked to confirmatory testing for Zika virus infection, according to study results recently published in JAMA Dermatology.
Researchers observed a man, aged 44 years, who returned from a vacation in Puerto Rico and experienced headache and lethargy within 3 days of his return. One day later, an erythematous eruption appeared on his arms, dorsal side of the hands and palms, which became more apparent and spread to his trunk 1 day later. Itching was not significantly noted, and the patient’s eyes appeared “bloodshot.”
By day 3, the eruption had migrated to the patient’s lower body, mostly on the knees and feet, with reported burning foot pain. Joint pain developed by day 4, and the patient remained febrile.
Erythematous eruption, arthralgia, and constitutional symptoms resolved by day 8.
Tiny pink and red erythematous papules were observed on the head, trunk and extremities during examination. Sclerae were injected and nonpurulent, while lymph nodes were not palpable.
Three days after the eruption was noted, Zika virus was detected in urine, using real-time PCR, but not in the patient’s serum. The serum was reactive for immunoglobulin M in enzyme-linked immunosorbent assay.
“The incubation period of Zika virus ranges from 3 to 12 days,” the researchers wrote. “Signs and symptoms include an exanthema (in 90% of patients), arthralgias (in 65%), nonpurulent conjunctivitis (in 55%) and headache,” the researchers wrote. “The exanthem has been described in nondermatology literature and ‘maculopapular’ or morbilliform.” The researchers, however, said in this patient it was comprised of “small papules.”
“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,” the researchers concluded. – by Bruce Thiel
Disclosure: The researchers report no relevant financial disclosures.
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