From the Guidelines
The clinical manifestations of an infected chickenpox rash include distinctive signs such as vesicular dermatomal rash or ulceration of eyelids, pleomorphic or nonexcavated pseudodendritic epithelial keratitis of cornea, and may be accompanied by symptoms like increased redness, warmth, tenderness, and swelling around the lesions. The infected areas may develop purulent discharge or pus, and the surrounding skin might show streaking redness indicating spreading infection, as noted in studies on conjunctivitis preferred practice patterns 1. Fever may persist or worsen beyond the usual chickenpox course, and patients might experience increased fatigue and malaise. The infected lesions typically fail to heal properly and may develop crusting that appears yellow or greenish rather than the normal brown scabs. Some key points to consider in the clinical manifestations of an infected chickenpox rash include:
- Increased pain compared to typical chickenpox lesions
- Development of purulent discharge or pus
- Streaking redness indicating spreading infection
- Fever persistence or worsening
- Increased fatigue and malaise
- Failure to heal properly with crusting
- Systemic symptoms like chills, increased heart rate, and general unwellness may indicate the infection is spreading beyond the skin, as discussed in the context of varicella zoster virus infections 1. Secondary bacterial infections of chickenpox lesions are most commonly caused by Staphylococcus aureus or Streptococcus pyogenes, which can enter through broken skin when patients scratch the intensely itchy lesions, and these infections require prompt treatment with appropriate antibiotics to prevent complications like scarring, sepsis, or invasive bacterial disease. It's also important to consider the potential for complications such as necrosis and scarring from vesicles on the eyelid margins, conjunctiva, and in the corneal stroma in primary disease in children, as well as conjunctival scarring from secondary infection leading to cicatricial ectropion, as noted in studies on varicella zoster virus infections 1. In recurrent disease, keratitis of the epithelium or stroma with subsequent scarring and late corneal anesthesia or dry eye, uveitis, retinitis may occur, highlighting the need for careful management and follow-up of infected chickenpox rash cases.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Clinical Manifestations of Infected Chicken Pox Rash
The clinical manifestations of an infected chicken pox rash can be identified through various studies, including 2, 3, 4, and 5.
- The rash of chickenpox is typically vesicular/pruritic and appears in crops over 3 successive days 3.
- VZV vesicles are fragile, superficial, and surrounded by an erythematous halo 3.
- Common nonspecific laboratory findings in chickenpox include leukopenia, thrombocytopenia, and elevated serum transaminases (serum glutamate-oxaloacetate transaminase/serum glutamate-pyruvate transaminase) 3.
- The erythrocyte sedimentation rate (ESR) is not highly elevated in chickenpox 3.
Complications of Chicken Pox Rash
Complications of chicken pox rash can occur, including:
- Secondary bacterial infections, especially with Group A streptococcus, and necrotising fasciitis 2.
- Viral (aseptic) meningitis, a rare CNS complication of VZV 3.
- Hypopyon sign, an unusual complication of varicella infection, which can occur in individuals with atopic dermatitis 5.
- Reactivation of herpes zoster infection by varicella-zoster virus, which can cause shingles 6.
Diagnosis and Treatment
Diagnosis of chicken pox rash is typically based on the appearance and distribution of the rash 3.