The Emerging Zika Virus Threat: A Guide for Dermatologists

Alice He; Patrícia Brasil; Andre M. Siqueira; Guilherme A. Calvet; Shawn G. Kwatra


Am J Clin Dermatol. 2017;18(2):231-236. 

In This Article

Abstract and Introduction


We provide a guide for dermatologists to follow if they encounter patients with a rash and clinical history suspicious of Zika virus infection, including diagnostic testing and management options. We also provide an illustrative case report of a patient from Brazil who was diagnosed with Zika virus infection after presenting with a generalized pruritic rash. One of the most prominent symptoms of Zika virus infection is a cutaneous eruption. As such, it is especially necessary for dermatologists to understand this virus so that they may appropriately recognize this entity as a diagnostic consideration in the clinic. The rash associated with Zika virus infection is most commonly an erythematous maculopapular eruption that presents after an initial 3–4 days of fever, headache, and arthralgia or myalgia. The rash typically lasts for an average of 6 days, and can spread to involve any part of the body, including the face, torso, extremities, palms, and soles.


The Zika virus is a flavivirus that is primarily transmitted to humans through the bite of Aedes mosquitoes.[1] It is closely related to the dengue virus, yellow fever virus, West Nile virus, and the Japanese encephalitis virus.[2] The Zika virus was first discovered in Uganda in 1947, and over the next few decades, only sporadic cases of human infections were reported.[2] In 2007, Zika virus presented as an outbreak for the first time outside its known endemic boundaries and caused an epidemic on Yap Island in the Federated States of Micronesia,[3] and then another epidemic in 2013 in French Polynesia.[4]

The recent outbreak of Zika virus in the Americas began in May 2015 in Brazil and has since spread to involve the USA, with over 3000 Zika virus cases reported in the USA as of September 2016, most of which were travel-related cases, except for the outbreak of cases identified in Florida.[5] The rapid spread of this virus is alarming, as the Centers for Disease Control and Prevention (CDC) announced that the Zika virus is spreading faster than anticipated. It is particularly necessary for dermatologists to understand this virus so that they may appropriately recognize this entity as a diagnostic consideration.