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Dermatological manifestations of measles infection in hospitalised paediatric patients observed in the 2009 - 2011 Western Cape epidemic
Abstract
Methods. We attempted to ascertain the prevalence of ‘non-classic’ dermatological measles presentation in 69 paediatric patients admitted to New Somerset Hospital, Western Cape, during the recent South African measles outbreak. The patients were examined and photographed, after informed consent had been obtained, and findings were assessed by 1 dermatology consultant and 6 dermatology registrars. Measles infection was confirmed in 38 of the patients by means of IgM testing. The data were analysed using Stata version 11.1 statistical software.
Outcomes. Of the group, 17.4% (95% CI 8.2 - 26.6%) displayed a classic measles dermatological picture, although all had been clinically diagnosed and admitted as complicated measles cases. Those serologically confirmed to have measles (N=38), 26.3% (95% CI 11.6 - 40.9%) conformed to the classic dermatological picture. Therefore, a significant majority of these patients presented with what was considered in this study to be a ‘non-classic’ dermatological picture.
Conclusions. Measles infection in a paediatric population requiring admission may frequently present without a full-house classic dermatological picture. Recognised signs in isolation may be of greater value than the classically described syndrome as a whole. ‘Non-classic’ dermatological forms may occur more frequently than anticipated in complicated cases needing admission. Skin necrosis may be associated with measles.
Authors' affiliations
Bianca Tod, Division of Dermatology, Groote Schuur Hospital and University of Cape Town
Henri Carrara, Faculty of Health Sciences, University of Cape Town
Michael Levin, Division of Allergy, Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, and University of Cape Town
Gail Todd, Division of Dermatology, Groote Schuur Hospital and University of Cape Town
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Article History
Date published: 2012-05-08
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