Transient cutaneous hyperpigmentation of extremities following dengue fever – Case Image

 
 A 14 year old boy presented with fever and generalized flushing of skin of 1 week duration. His vital signs were normal. Examination revealed generalized blanching macular erythematous rash. Systemic examination was unremarkable except for tender hepatomegaly. Investigations revealed leucopenia, thrombocytopenia and normal hemoglobin with mildly elevated liver transaminases. NS 1 (Non-structural protein-1) antigen and IgM antibody titer for Dengue ELISA was positive suggesting dengue fever. He was managed symptomatically and he recovered. During his follow up after 2 weeks he presented with brownish discoloration of dorsum of both hands and feet. There was no history of intake of any medication. 

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