Skin and mucosal manifestations of chikungunya virus infection in adults in Reunion Island

Numerous skin and mucosal manifestations were observed during the 2005-2006 chikungunya epidemic in Reunion Island. A prospective study was carried out in a consecutive series of 212 patients treated for chikungunya at the emergency unit of the Saint-Pierre Hospital in Reunion Island from March 8 to April 27, 2006. Diagnosis of chikungunya was suspected in patients with fever and joint pain and confirmed by RT-PCR and/or serology (IgM). Skin involvement was observed in 50% of patients. It consisted of exanthema with patches of healthy skin mainly on the trunk and limbs that sometimes displayed diffuse, congestive and even edematous features. Itching was reported in some cases (19.3%) and was sometimes isolated. Peeling of the skin was observed in a few cases but remained uncommon in adults. Outcome was rapidly favorable in most cases sometimes with scaling or persistence of dyschromic patches. These findings suggest that chikungunya should be suspected in subjects presenting a febrile rash while in an endemic areas or after returning from a tropical zone.