Cutaneous Manifestations in Chikungunya- A Systematic Review and Meta-analysis.

Area of Science:

• Dermatology
• Infectious Diseases
• Public Health

Background:

• Chikungunya fever is a significant arboviral disease with prominent fever and joint pain.
• Cutaneous manifestations are frequent but widely reported, necessitating a consolidated overview.
• This review synthesizes data on the dermatological aspects of Chikungunya infection.

Purpose of the Study:

• To systematically review and consolidate data on the dermatological manifestations of Chikungunya.
• To determine the pooled prevalence of various skin symptoms associated with Chikungunya infection.

Main Methods:

• A systematic review and meta-analysis adhering to PRISMA guidelines.
• Inclusion of 65 studies with 42,011 Chikungunya cases, identified through comprehensive database searches.
• Meta-analysis employed a random-effects model, with heterogeneity assessed using the I2 statistic.

Main Results:

• The pooled prevalence of rash was 41%, with erythematous maculopapular rash at 29%.
• Other common findings included pruritus (29%), hyperpigmented macules (13%), and centro-facial hyperpigmentation (10%).
• Substantial heterogeneity (I2 > 95%) and low to very low certainty of evidence were noted.

Conclusions:

• Cutaneous manifestations are common and varied in Chikungunya, with rash, hyperpigmentation, and pruritus being predominant.
• Significant heterogeneity and potential reporting bias highlight the need for standardized dermatological documentation.
• Higher-quality studies are essential for improved clinical characterization and surveillance of Chikungunya outbreaks.