A male patient with history of fever, joint and back pain develops hyperpigmentation over the nose after 5 days of taking NSAID’s. Diagnosis?

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A male patient with history of fever, joint and back pain develops hyperpigmentation over the
nose after 5 days of taking NSAID’s. Diagnosis?

  • A. Melasma
  • B. Fixed drug eruption
  • C. Dengue
  • D. Chikungunya

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EXP:

Ans: D. Chikungunya
Exp : Chikungunya (CKG) is acute febrile illness with incapacitating
polyarthralgia, headache, vomiting, sore throat, conjunctivitis and skin
eruptions. It is usually self-limiting and rarely fatal. The most common
cutaneous lesion described in CKG is erythematous maculopapular rash
affecting trunk, limbs and face. The abundance of Aedes albopictus and
mutations in glycoprotein envelope (E1) gene of CHIKV may be the
contributory factors for repeated outbreaks. Nose was pigmentation
striking in several cases of CKG which has not been reported in any
other viral exanthem. Its presence and persistence for about three to
six months after an attack of CKG helps to make a clinical and
retrospective diagnosis of CKG. Hence, this may be considered as a
marker of CKG, and we suggest ‘chik sign’ for this peculiar
pigmentation.