Chikungunya Effect on Skin: What You Need to Know

Introduction

Fighting with Mosquitoes is still a dare for many people. Mosquito-borne diseases are usually those spread by the bite from the mouth of an infected mosquito. Common diseases that are transmitted to people of all age groups by mosquitoes are Zika virus, West Nile virus, dengue, and malaria. Apart from these diseases, there is another threatening illness caused by the Mosquito, which is none other than Chikungunya. 

How many of you know that Chikungunya causes skin rashes since it is a disease spread by mosquitoes? Although many people might not feel sick following a bite from an infected mosquito, a few people experience a mild, brief illness or (rarely) severe or long-term illness apart from skin rashes. In some cases, painful conditions of mosquito-borne diseases can cause death.

Chikungunya fever’s first outbreak was documented in Tanzania in 1952. Since then, it has been identified in over 60 countries worldwide. It is most prevalent in Africa, Asia, and the Indian subcontinent. India recorded the first outbreak of Chikungunya in the Cultural Capital of India, Calcutta, in 1963, followed by epidemics in Tamil Nadu, Andhra Pradesh, and Maharashtra till 1973.

What is Chikungunya?

Chikungunya, also called chikungunya virus disease or chikungunya fever, is a viral infection or illness that gets transmitted due to the bite of infected mosquitoes. In the Swahili language, Chikungunya refers to contorts or bends. This points to the contorted (or stooped) posture of patients suffering from severe joint pain (arthritis), a common disease symptom.

Following a quiescent period after 1973, India saw the re-emergence of Chikungunya infection in 2006. Since then, regular outbreaks have been recorded in different states of India.

Chikungunya Effect on Skin: What You Need to Know?

Chikungunya (CHK) is a mosquito-borne viral disease characterized by high fever, predominant musculoskeletal symptoms, and skin rash.

• A maculopapular rash is commonly seen in the first 2–3 days of the illness and exists within 7–10 days.
• The rash can be patchy or diffuse on the face, limbs and trunk. 
• The rash on the skin forms slowly within 3–4 days of the onset of fever and tends to decrease its severity in about a week without any outcome. 
• Skin hyperpigmentation is the following symptom. It might occur in the form of centrofacial pigmentation primarily involving the nose.

As per research, isolated nail pigmentation without any skin lesions in two cases of serologically confirmed Chikungunya, feverish episodes and a maculopapular rash often coincide with periods of viremia.

• The most frequently reported manifestation, occurring in approximately 30 to 55 percent of cases, is a widespread rash resembling measles and consists of flat red spots with normal skin patches. 
• Typically, this rash spares the face. Different skin lesions may be observed in infants younger than 12 months, including acrocyanosis (bluish discolouration of the extremities) and symmetrical superficial blisters.

Chikungunya infection can be attributed to dengue and rickettsial fever, also known to cause sudden-onset febrile illnesses accompanied by severe arthritis and skin rash. Rickettsial infection typically presents as a distinct red rash with small raised spots, initially appearing on the lower leg and ankle and then spreading inward to cover the entire body, including the palms and soles.

How to treat skin after getting chikungunya?

Most skin lesions usually clear up within two weeks, but reversible post-inflammatory hypopigmentation may occur.

• To treat the skin rash, it is generally recommended to use saline compresses and moisturizers. 
• Persistent non-healing ulcers in the genital and skin-fold areas and skin erosion resulting from burst blister-like lesions can be addressed with topical or systemic antibiotics. 
• With the regular diagnosis of chikungunya infection, it is necessary for dermatologists to stick with the presentations of mucocutaneous to suspect chikungunya infection early before the laboratory investigations are available.

Causes of Chikungunya 

Chikungunya is caused by a virus named Chikungunya, which belongs to the Togaviridae genus Alphavirus family. It is a reoccurring viral infection spread to humans by infected mosquitoes. 

The etiological agent is an RNA virus that comes under the alphavirus genus of the family Togaviridae. In Asia, Chikungunya is transmitted to people by the bite of infected Aedes mosquitoes of two species, Aedes aegypti and Aedes albopictus.

These two types of mosquitoes can also transmit other diseases, like dengue. Both these generally bite throughout the early morning and late afternoon daylight hours.

Symptoms of Chikungunya 

Several people, including newborn infants infected at the time of their birth, senior citizens (≥60 years), and people with severe medical conditions like high blood pressure, diabetes, or heart disease, are affected by this condition.

Chikungunya begins abruptly with the following symptoms: 

• Fever
• Joint pain 
• Rashes 
• Chills
• Headache
• Nausea
• Vomiting

Primarily, the infection causes no symptoms, especially in children. Several patients get well within a week. However, some of them get joint pain and disability persisting for months.

Chikungunya Diagnosis

Chikungunya virus may be found directly in blood samples appropriately collected during the first week of illness using common identification tests like reverse transcriptase–polymerase chain reaction (RT–PCR). 

• Visit your healthcare provider if you have visited an area where the Chikungunya virus is found and have the symptoms mentioned above.
• Frankly, tell your healthcare provider when and where you travelled and if it is a Chikungunya-affected area.
• Your healthcare provider may request that you conduct blood tests to check for Chikungunya or other similar viruses like Zika and dengue. 
• Other tests could determine a person’s immune response to chikungunya virus infection. These tests are conducted typically after the first week of infection to test for antibodies to the virus. The antibody levels could be identified by the first week after the illness’s condition onset, and they are still detected for about two months. 

The reverse transcription-polymerase (RT–PCR) chain reaction test is a common test for diagnosing viral diseases like SARS-CoV-2 virus infection and Ebola. This test is a sensitive method. 

Chikungunya Treatment 

Currently, there is no medicine to treat Chikungunya. Long rest, fluids, and anti-pain medication may relieve some symptoms.

• Use acetaminophen or paracetamol to minimize severe fever and pain.
• Though there is no treatment, drugs like paracetamol, chloroquine, and diclofenac sodium relieve fever, swelling and joint pains. 
• Do not consume aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs), as they might cause other unnecessary conditions. 
• If you are affected by Chikungunya, protect yourselves from mosquito bites for the first week of your illness.

During the first week of this condition, the chikungunya virus can be found in the blood. The Chikungunya virus could get transmitted from an infected person to a mosquito through mosquito bites. After that, an infected mosquito might spread the virus quickly to other people.

Prevention of Chikungunya 

Prevention of Chikungunya outbreaks depends on reducing the vector population and vector–patient contact. 

• Reducing the vector population could be done by boosting community education and active participation in preventing extra aboding water that is breeding areas for mosquitoes. 
• To reduce vector patient contact, insecticide sprays and full-sleeved bright-coloured clothing could be used. 
• You could use wire mesh or net on the doors and windows. 
• Proper diagnosis will debar the diagnostic tests needed. 

Conclusion 

Other than unemployed people, all working people should also protect themselves from diseases caused by mosquitoes. Skin rashes could occur because of several mosquito-borne diseases. While betterment from Chikungunya is the most expected result, prolonged and persistent joint pain necessitates analgesic (pain medication) and some anti-inflammatory therapy. Infection confers ever-lasting immunity. Death from Chikungunya is rare. 

If your skin is affected because of Chikungunya, then you can try the simple tips to cure skin rashes, as mentioned in this article. So, it is also the responsibility of each individual to protect themselves from mosquitoes. You can use all the preventive measures to prevent yourself and your society from mosquito-borne diseases completely. If you are affected by Chikungunya, follow the abovementioned methods to treat the condition.

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