{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T22:16:26Z","timestamp":1775081786986,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,3,21]],"date-time":"2013-03-21T00:00:00Z","timestamp":1363824000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2014,5]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Crimean Congo Haemorrhagic Fever (CCHF<\/jats:styled-content>) is a deadly fever caused by Nairovirus (family Bunyaviridae<\/jats:italic>). It is an important public health problem in hyperendemic regions with a high mortality rate. There have been many studies on cutaneous findings in other viral infections, however, our knowledge is limited regarding CCHF<\/jats:styled-content>. The aim of this study was to evaluate the cutaneous manifestations of CCHF<\/jats:styled-content> and their relationship with mortality.<\/jats:p><\/jats:sec>Methods<\/jats:title>Patients who were diagnosed CCHF<\/jats:styled-content> between April 1 and September 1, 2011 were enrolled in this study. Dermatologic examination and laboratory analysis were obtained during hospitalization.<\/jats:p><\/jats:sec>Results<\/jats:title>A new entity that is first reported in this study as a butterfly\u2010like facial rash was recognized in 76 patients (42.9%). It was not correlated with mortality but could coexist with other dermatological signs of CCHF<\/jats:styled-content>. The major outcome was the increased mortality rate with other cutaneous findings (especially ecchymosis, purpura and petechia) (P<\/jats:italic>\u00a0<\u00a00.01). While 12 deceased individuals had one or more skin findings, only one patient died without any cutaneous manifestations. Mortality rate was higher in patients with purpura than the patients with pethesia. The statistically significant correlation was observed between cutaneous manifestations and elevation of aspartate aminotransferase (AST<\/jats:styled-content>) levels (P<\/jats:italic>\u00a0=\u00a00.009). Platelet levels were lower in patients with cutaneous involvement (P<\/jats:italic>\u00a0<\u00a00.01). No statistically significant relationship was found between cutaneous findings and alanine aminotransferase (ALT<\/jats:styled-content>), white blood cell (WBC<\/jats:styled-content>), Haemoglobin (Hb), creatinine kinase (CK<\/jats:styled-content>) and lactate dehydrogenase (LDH<\/jats:styled-content>) levels.<\/jats:p><\/jats:sec>Limitations<\/jats:title>Histopathologic examination of facial rash could not be done because of haemostatic failure.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>The results of this study confirm that cutaneous findings can be a clue regarding the prognosis of the patients with CCHF<\/jats:styled-content>. Physicians should be aware that CCHF<\/jats:styled-content> may present with a butterfly\u2010like rash on the face.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.12145","type":"journal-article","created":{"date-parts":[[2013,3,28]],"date-time":"2013-03-28T10:09:59Z","timestamp":1364465399000},"page":"604-608","source":"Crossref","is-referenced-by-count":6,"title":["The prognostic role of the new entity butterfly\u2010like facial rash and cutaneous findings in patients with crimean congo haemorrhagic fever"],"prefix":"10.1111","volume":"28","author":[{"given":"G.S.","family":"Pancar","sequence":"first","affiliation":[{"name":"Department of Dermatology Medicalpark Samsun Hospital Medicalpark Health Group Samsun Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Duygu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases School of Medicine Gaziosmanpasa University Tokat Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Kalkan","sequence":"additional","affiliation":[{"name":"Department of Dermatology School of Medicine Gaziosmanpasa University Tokat Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,3,21]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/vbz.2011.0651"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2004.08.001"},{"key":"e_1_2_5_4_1","doi-asserted-by":"crossref","first-page":"18953","DOI":"10.2807\/ese.13.33.18953-en","article-title":"A preliminary report on Crimean\u2010Congo haemorrhagic fever in Turkey, March\u2010June 2008","volume":"13","author":"Yilmaz GR","year":"2008","journal-title":"Euro Surveill"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/500836"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.45865-0"},{"key":"e_1_2_5_7_1","first-page":"33","article-title":"Epidemiological evaluation of a possible outbreak in and nearby Tokat province (in Turkish)","volume":"38","author":"Gozalan A","year":"2004","journal-title":"Microbiyol Bul"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2005.05.003"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974-777X.83537"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1258\/td.2009.090359"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/jmedent\/15.4.307"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.46910-0"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfl248"},{"key":"e_1_2_5_14_1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.5070\/D32DX685HC","article-title":"Letter: Adult measles with a butterfly rash\u2010like appearance","volume":"16","author":"Tsuruta D","year":"2010","journal-title":"Dermatol Online J"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.3109\/15569520903178208"},{"key":"e_1_2_5_16_1","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1684\/ejd.2010.0973","article-title":"Cutaneous manifestations of Crimean\u2010Congo haemorrhagic fever: morbilliform eruptions may reflect a favourable outcome and not low platelet levels","volume":"20","author":"Akyol M","year":"2010","journal-title":"Eur J Dermatol"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/11.Supplement_4.S794"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365540903582418"}],"container-title":["Journal of the European Academy of Dermatology and Venereology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjdv.12145","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjdv.12145","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.12145","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T10:34:21Z","timestamp":1696242861000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdv.12145"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,3,21]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2014,5]]}},"alternative-id":["10.1111\/jdv.12145"],"URL":"https:\/\/doi.org\/10.1111\/jdv.12145","archive":["Portico"],"relation":{},"ISSN":["0926-9959","1468-3083"],"issn-type":[{"value":"0926-9959","type":"print"},{"value":"1468-3083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,3,21]]}}}