Could Hair Loss be a Relevant Symptom Associated with Chikungunya?

Chikungunya (CHIK) is a disease caused by a mosquito-borne alphavirus (the mosquitos Aedes aegypti or Aedes albopictus). The chikungunya virus (CHIKV) is present all over the world. Several clinical symptoms have been associated with CHIK including hair loss. The aim of this review is to present some symptoms related to CHIK, tissues and organs targeted by the CHIKV and to suggest how the infection can lead to hair loss. Searches were performed to verify the number of publications (NP) with the keywords “Chikungunya” and (i) “fever, or arthralgia, or rash, or myalgia, or fatigue, or depression, or insomnia, or pruritus, or patches, nausea, or vomiting, or headache, or erythema or hair loss” and (ii) some organs or tissues that are target to the arboviral alphaviruses associated with this disease. The total number of articles with the keyword “chikungunya” was 3176. Fever was the most cited symptoms and 50% of the publications were related to this symptom. Also, hair loss was found to be associated with CHIKV infection. Skin being the most cited organ, the total number of publications with “skin” under chikungunya summed up to only 2.77%. Although, fever is the most reported, arthralgia and rash have an important NP, and (ii) the main targets of CHIKV would be skin, kidneys and brain. A small NP is found with CHIK and hair loss. Hair loss may be idiopathic, and would be associated with a genetic predisposition, metabolic and hormonal abnormalities and aging. Also, as hair does not have a vital function in humans, it is possible to say that hair loss could not be considered in the clinical evaluation of the patient with CHIK. It is therefore possible to conclude that occurrence of hair loss is underestimated in CHIK.