Urticaria is a very uncommon dermatological manifestation of infection by the dengue virus. It can hinder diagnosis since some of its features overlap with allergic conditions, such as maculopapular and petechial rashes. We present a case of a 32-year-old male, resident of a dengue-endemic area, who presented with an acute onset of generalized pruritic wheals and angioedema in the absence of any systemic symptoms, including fever. Laboratory tests showed leukopenia, thrombocytopenia, and elevated liver enzymes. Dengue serology confirmed primary infection (NS1 antigen and IgM positive). The patient responded to antihistamines and supportive care without complications. This case highlights the need to consider dengue in the differential diagnosis of acute urticaria in endemic areas, even without typical systemic symptoms.
Goni et al. (Sun,) studied this question.