Severe bullous skin lesions associated with Chikungunya virus infection in small infants.
BACKGROUND
The aim of this study was to describe a pediatric case series of Chikungunya infection associated with extensive bullous skin lesions, a severe and unknown form of the disease, during the 2005-2006 outbreak in La Réunion Island.


METHODS
Retrospective descriptive hospital-based study in children presenting blisters > or = 10% of total body surface area with laboratory-confirmed Chikungunya infection.


RESULTS
Eight boys and five girls with a mean age of 3.4 months were included. Blistering began after an average of 2 days after onset of fever and affected 21.5% (10% to 35%) of the total body surface area. Reverse transcription-polymerase chain reaction of blister fluid (n = 5) was positive with a mean viral load sometimes higher than in concurrent serum. Histopathologic examination (n = 10) showed intraepidermal blisters. Hospitalization and repeated dressing changes under general anesthesia were required. No death occurred. On follow-up, long term repigmentation was excellent with sometimes cosmetic sequelae.


CONCLUSIONS
Chikungunya should be included in the differential diagnosis of febrile blistering dermatoses in small infants in epidemic areas.
Robin
Stéphanie
S
Service de Pédiatrie, Centre Hospitalier Félix Guyon, CHR Réunion, Allée des Topazes, 97405 Saint-Denis, La Réunion, France. stephanie.robin@chr-reunion.fr
Ramful
Duksha
D
Zettor
Julie
J
Benhamou
Léon
L
Jaffar-Bandjee
Marie-Christine
MC
Rivière
Jean-Pierre
JP
Marichy
Jacques
J
Ezzedine
Khaled
K
Alessandri
Jean-Luc
JL
D018354:Alphavirus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D000914:Antibodies, Viral / Q000032:analysis; D001706:Biopsy; D002646:Chikungunya virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D004279:DNA, Viral / Q000032:analysis; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000008:administration & dosage; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology / Q000821:virology; D012872:Skin Diseases, Vesiculobullous / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D016896:Treatment Outcome; D019562:Viral Load
D000914:Antibodies, Viral; D004279:DNA, Viral; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors