Mucocutaneous Manifestations of Dengue Fever and Its Correlation with Disease Severity: A Cross-Sectional Study.

Abstract

Introduction: Dengue fever (DF), a mosquito-borne viral illness, has seen a rise in cases worldwide, including Nepal. While systemic manifestations are well-documented, mucocutaneous lesions are less studied.

Objectives: This study aims to identify the mucocutaneous manifestations of DF and explore their correlation with disease severity, marking the first such effort in Nepal. 

Materials and Methods: This hospital-based descriptive cross-sectional study was conducted between August 2023 to July 2024 at a tertiary care center in Kathmandu, Nepal. Ethical approval was obtained from the Institutional Review Committee. Non-probability convenience sampling was used. A total of 151 patients clinically diagnosed with DF and confirmed by NS1 antigen and/or IgM positive tests were included.

Results: The prevalence of DF among suspected cases in our center was 16.51% (95% CI: 14.97–18.18). 93(61.59%) had mucocutaneous involvement, 42 (27.81%) had cutaneous lesions only, and 10(6.62%) had mucosal involvement only. Both mucosal and cutaneous manifestations were identified in 41(27.15%) patients. The most common rash was maculopapular, as seen in 55(36.42%). Pruritus was reported by 65(43.04%) of patients, and it was significantly correlated with mucocutaneous involvement (p<0.05).  Disease severity classification showed 87 (57.62%) had dengue without warning signs, 52 (34.44%) with warning signs, and 12(7.95%) with severe dengue. Mucocutaneous manifestations were not significantly associated with disease severity in this study.

Conclusion: Mucocutaneous manifestations, including maculopapular rashes and pruritus, are common in DF, but they do not necessarily correlate with disease severity. Identifying these signs early can improve diagnosis and management.