From the Guidelines
Chickenpox lesions typically occur at different stages of development, with a mixture of lesions including red macules, fluid-filled vesicles, pustules, and crusted scabs all present simultaneously on the body. This characteristic is a key diagnostic feature of the disease, as noted in a study published in Pediatrics in 2007 1. The study describes the clinical manifestations of varicella, including the development of skin lesions in varying stages of development and resolution.
Key Features of Chickenpox Lesions
- Lesions begin as macules and rapidly progress to papules, vesicles, pustules, and scabs
- Fever and rash last approximately 5 days
- Rash is more concentrated on the trunk and head than on the extremities
- Lesions frequently develop in the mouth, conjunctivae, or other mucosal sites In contrast to smallpox, where lesions tend to be in the same stage of development, chickenpox lesions are typically in different stages, as described in a study published in the Morbidity and Mortality Weekly Report in 2001 1.
Clinical Implications
The presence of lesions in various stages is so typical that it's considered a hallmark sign when diagnosing chickenpox clinically. Treatment focuses on symptom management with antihistamines for itching, acetaminophen for fever (avoiding aspirin due to Reye's syndrome risk), and keeping lesions clean to prevent secondary bacterial infections.
From the Research
Characteristics of Chickenpox Lesions
- Chickenpox (varicella) lesions can occur at different stages, including macular, papular, vesicular, pustular, and crusts 2
- It is possible to concurrently identify lesions in their various stages in varicella 2
- In contrast to monkeypox, where lesions are all in the same stage and evolve at the same rate, varicella lesions can be at different stages simultaneously 2
Comparison with Other Diseases
- Varicella (chickenpox) is a highly infectious disease caused by the Varicella zoster virus, and its lesions can be distinguished from those of other diseases such as monkeypox and smallpox 3, 2
- The clinical diagnosis of monkeypox infection is commonly made based on the occurrence pattern of its skin rash, which is different from varicella 2
Treatment and Management
- The treatment of chickenpox typically focuses on managing symptoms, as the role of antivirals such as acyclovir is still controversial, particularly in children and adolescents 3, 4
- Acyclovir may be effective in reducing the number of days with fever and the maximum number of lesions among otherwise healthy children with chickenpox, but its clinical importance remains controversial 4