# Dermatologic Clues to Emerging Tropical Infections: A Narrative Review for Early Recognition and Differential Diagnosis

## TL;DR

This review highlights how skin symptoms can help diagnose tropical infections early, emphasizing the need for better recognition and collaboration between specialists.

## Contribution

The paper systematically evaluates dermatologic clues across over 25 tropical infections and proposes strategies to improve early diagnosis and outbreak response.

## Key findings

- Dermatologic signs can serve as early indicators for tropical infections when interpreted with local epidemiology.
- Many tropical infections share overlapping skin symptoms, but specific lesion patterns can aid preliminary diagnosis.
- Standardized terminology and clinician training in dermatologic recognition are recommended to improve outbreak preparedness.

## Abstract

Tropical infections often present with characteristic dermatologic manifestations, which can serve as early indicators for diagnosis. However, these signs are frequently misidentified or underreported in emerging and outbreak settings. This narrative review critically evaluates the diagnostic utility of dermatologic findings across over 25 tropical infections, spanning viral (e.g., dengue, Zika, chikungunya, Mayaro virus, O’nyong-nyong virus), bacterial (e.g., Bacillus anthracis, Mycobacterium ulcerans, Rickettsia spp.), parasitic/helminthic (e.g., Loa loa, Ancylostoma braziliense, Tunga penetrans, Gnathostoma spinigerum), and fungal pathogens (e.g., Fonsecaea pedrosoi, Paracoccidioides brasiliensis). A thematic synthesis was conducted using peer-reviewed case reports, outbreak investigations, and cross-specialty literature bridging dermatology and infectious diseases. Emphasis was placed on lesion patterns, geographic distribution, climate and seasonal influences, and clinical interpretability. Findings indicate that although many infections share overlapping cutaneous features, certain lesion patterns can aid preliminary diagnosis when interpreted in the context of local epidemiology. Limitations include reliance on anecdotal data, nonstandardized terminology, and underinvolvement of dermatologists in outbreak settings. The review concludes that dermatologic signs remain an underutilized but essential tool for early detection. Recommendations include adopting standardized dermatologic terminology, improving clinician training in skin-based recognition, and enhancing collaboration between dermatology and infectious disease specialists. Recognizing cutaneous manifestations can facilitate rapid case identification, optimize public health responses, and improve outbreak preparedness in tropical regions.