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Published on: August 23, 2016
Cutaneous Manifestations of Zika in Peru
Willy Ramos1,2, Miguel Luna3, Tania Alarcón3
1504671 National Center of Epidemiology, Control and Prevention of Diseases, Ministry of Health, Lima, Peru.
Abstract:
This article aims to describe the cutaneous manifestations observed in the Zika epidemic in Peru during 2016 and 2017, as well as discuss the potential differential diagnoses. During the outbreak, the main reason for seeking medical advice was the development of a pruriginous maculopapular rash with a marked papular component, which started on the chest and later generalized to the rest of the body. Similar manifestations were noted in adults, children, and pregnant women. Other manifestations such as conjunctivitis, edema, or petechiae on the palate were rare. We suggest that in areas that are endemic for arboviral infections, in the differential diagnosis of a rash one must consider infections such as dengue, Zika, or chikungunya viruses. In nonendemic areas, the diagnosis is more difficult, as the rash may result from other viral infections not transmitted by arthropods and/or reactive or inflammatory diseases (urticaria, atopic dermatitis, systemic lupus erythematosus). We recommend that primary care health personnel are trained in the recognition of the mucocutaneous lesions caused by Zika virus infection, which could contribute to the identification of suspicious cases, particularly pregnant women.
Insights
The Zika virus epidemic in Peru (2016-2017) primarily caused a widespread, itchy rash. Recognizing these skin symptoms is crucial for diagnosing Zika, especially in pregnant women, and differentiating it from other arboviral diseases.
Area of Science:
- Dermatology
- Infectious Diseases
- Epidemiology
Background:
- The Zika virus epidemic in Peru (2016-2017) presented unique challenges for diagnosis.
- Cutaneous manifestations are key indicators of arboviral infections.
Purpose of the Study:
- To describe the skin symptoms observed during the Zika epidemic in Peru.
- To discuss differential diagnoses for these mucocutaneous lesions.
- To emphasize the importance of recognizing Zika symptoms in primary care.
Main Methods:
- Observational description of cutaneous manifestations during the 2016-2017 Zika outbreak in Peru.
- Analysis of clinical presentations across different demographics (adults, children, pregnant women).
- Review of differential diagnoses in endemic and non-endemic settings.
Main Results:
- The predominant symptom was a pruritic maculopapular rash, often starting on the chest and generalizing.
- The rash presentation was consistent across adults, children, and pregnant women.
- Conjunctivitis, edema, and palatal petechiae were infrequent findings.
Conclusions:
- In arbovirus-endemic areas, consider Zika, dengue, and chikungunya in rash differential diagnoses.
- In non-endemic areas, other viral infections and inflammatory conditions should be considered.
- Training primary care health personnel to recognize Zika-related mucocutaneous lesions is recommended for early case identification, particularly in pregnant women.
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